Objectives

Vitamin D is an essential hormone involved in calcium and bone homeostasis and has also been shown to modulate critical aspects of innate and adaptive immunity. The associations among human papilloma virus (HPV) infection, vitamin D, and oral and oropharyngeal cancer (OOPC) have yet to be described; we propose to address this gap in knowledge by exploring the relationship between serum vitamin D levels, cancer site, and HPV status in a cohort of patients with OOPC.

Study Design

A retrospective chart review of patients seen at the Dana-Farber Cancer Institute from January 1999 to December 2017 was conducted. Data collected included patient demographic characteristics, vitamin D serum levels, oncologic history, and HPV-16 status (polymerase chain reaction and immunohistochemistry for p16). Patients with vitamin D serum levels obtained within 1 year before and 1 year after the OOPC diagnosis were included in this analysis. Vitamin D levels less than 20 ng/mL and less than 30 ng/mL were considered deficient and insufficient, respectively. A logistic regression analysis was conducted to assess the relationship between vitamin D serum levels, HPV-16 status, and site of cancer. A P value less than 0.05 was considered significant.

Results

One hundred and twenty-three patients were included (70.7% males; n = 87; median age 62 years; range 27–91 years). Eighty-nine patients were diagnosed with OPC (72.3%) and 34 (27.6%) with oral cancer (OC). The most prevalent sites were the base of the tongue (34%; n = 42) and tonsils (28.4%; n = 35). Of the tumors tested for HPV-16 (n = 64), 78.1% were positive. Median vitamin D serum level was 30 ng/mL (range 6–82 ng/mL); 19.5% (n = 24) of individuals were deficient in vitamin D, 30% (n = 37) had insufficient levels, and the remainder of patients had sufficient serum vitamin D levels. Neither OC/OPC nor HPV-16 status in OPC was significantly correlated with vitamin D serum level in this cohort (P > .05).

Conclusions

In our cohort, vitamin D serum levels did not seem to play a role in HPV-positive OPC, OC, or OPC in general. Further larger studies are needed to evaluate the potential association between vitamin D deficiency and head and neck cancer risk.