A survey of head and neck pathologists in the UK and Ireland revealed that in-house access to HPV-specific testing in oropharyngeal squamous cell carcinoma is not widely available and use of the test is not standardized.
Here, Hannah Crane reports key findings from a study presented at ECP 2026.
Hannah Crane is NIHR Clinical Lecturer in Oral and Maxillofacial Pathology at the University of Sheffield, UK.
The following transcript has been edited for clarity.
Hello, my name is Hannah, and I am an NIHR Clinical Lecturer and Specialist Registrar based at the University of Sheffield. Today, I'm going to give you a brief overview of our work looking at HPV-specific testing in oropharyngeal squamous cell carcinoma.
As many of you will be aware, oropharyngeal squamous cell carcinoma has two main clinical subtypes: HPV-associated and HPV-independent with differing clinical outcomes. P16 immunohistochemistry is a commonly used surrogate marker. However, use of HPV direct testing, such as PCR or in situ hybridization, is becoming increasingly common.
We were interested in current practice with regard to HPV-specific testing across the UK and Ireland, and in order to investigate this, we carried out a survey of UK- and Ireland-based consultant head and neck pathologists earlier this year.
We received forty-four valid responses, and the majority of respondents practice in England. Interestingly, a hundred percent of respondents had access to P16 immunohistochemistry in-house. However, HPV-specific testing told a different story. Whilst ninety-one percent of respondents had access to HPV-specific testing, most commonly PCR, only twenty-five percent of respondents had access to this in-house. This led to a median reported turnaround time of fourteen days for HPV-specific testing, compared to two days for P16 immunohistochemistry.
Reported practice also varied, with the majority of respondents, thirty-six percent, reporting that they requested HPV-specific testing in select cases based on clinical suspicion.
Overall, we found that pathologists reported that HPV-specific testing is beneficial with regards to improving diagnostic accuracy and complying with emerging guidelines. However, cost and turnaround times remain significant barriers.
Overall, our findings show that HPV-specific testing practice varies across the UK and Ireland, and work to address the barriers will be needed as we move towards standardizing patient pathways.
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