We have just published our 12-year retrospective study, “Epidemiological Trends and Diagnostic Evolution of HPV-Related Oropharyngeal Cancer in a Spanish Tertiary Center”, in Revista ORL (2025).
First and foremost, I would like to acknowledge Juan Manuel Granados Sitges, who collected and analyzed the data and led the drafting of the manuscript. This work would not have been possible without his rigorous and sustained effort.
The Key Message: 43%, and Probably Climbing
In our cohort of 107 patients with oropharyngeal squamous cell carcinoma (OPSCC) diagnosed between 2012 and 2024, HPV status was available in 81 cases. 43.2% of tested patients were HPV-positive. This figure is striking for Spain.
Previous national reports described HPV-related OPSCC rates between 1.8% and 7.4%. Our data show a completely different landscape. Even more importantly, our 43% average likely underestimates the current reality. Why?
- HPV testing was not systematic in the early years.
- p16 immunohistochemistry (IHC) only became routine after implementation of the 8th TNM edition in 2018.
- Earlier selective testing may have introduced bias in both directions.
Given the sustained upward international trend and what many of us are observing in daily practice, it would not be surprising if we are already above 50% today. In other words: HPV-related OPSCC is no longer a minority entity in Spain. It may soon represent the majority.
The shift toward standardized p16 testing likely improved detection and reduced underdiagnosis. Our relatively stable rates across periods suggest that diagnostic evolution, not sudden epidemiological change, explains much of the discrepancy with older Spanish literature. This reinforces a critical point:
Without systematic HPV testing, we underestimate the burden.
And underestimation affects:
- Staging
- Prognosis
- Treatment decisions (including de-intensification strategies)
- Public health planning
Why This Matters Now
Internationally, HPV-related OPSCC has become the dominant subtype in Northern Europe and North America. Spain appears to be following the same path. Perhaps later, but steadily. If we are indeed approaching or surpassing 50% prevalence:
- Prevention strategies (vaccination) become even more crucial.
- Public awareness must increase.
- Multicenter Spanish data are urgently needed.
We must refine how we characterize the “new” oropharyngeal cancer patient profile.
In this context, the work of the Asociación HPV Madrid is especially relevant, promoting awareness, prevention, and education around HPV-related disease.
For those looking for practical information, I have previously published an FAQ post on HPV that may be helpful for clinicians and patients alike.
Looking Ahead: Discussion in Madrid (June 2026)
These findings will feed directly into the round table discussion at the XVIII Congress of the Asociación Madrileña de Otorrinolaringología (AMORL), to be held at Hospital Universitario Infanta Leonor on June 11–12, 2026.
Hospitals from across the region will share incidence, HPV prevalence, survival outcomes and patient characteristics. This will be an excellent opportunity to compare real-world data and determine whether what we are seeing locally reflects a broader regional shift.
Let’s Open the Discussion
Are we underestimating HPV-related OPSCC in Spain?
Have we already crossed the 50% threshold?
Are our diagnostic protocols truly standardized across centers?
I look forward to continuing this conversation in Madrid, and here. Your thoughts and experiences are welcome.
J Granell. Feb 17, 2026
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