Disparities in contemporary human papilloma virus vaccination uptake among adult women living in the United States: An All of Us Research Program study.

OBJECTIVE: Age-adjusted rates of new cervical cancer diagnoses in the United States have remained stable despite increasing availability of Human Papilloma Virus (HPV) vaccination. As it is well established that sociodemographic factors drive cervical cancer care inequity, we aimed to evaluate their impact on catch-up HPV vaccination rates in adults. METHODS: The All of Us (AoU) Research Program is a longitudinal cohort study sponsored by the National Institutes of Health. All participants ages 18-47 assigned female sex at birth enrolled between May 2018 and April 2023 were included in this analysis. Primary outcome was receipt of HPV vaccination. Bivariable and multivariable tests were used to examine associations. RESULTS: A total of 113,344 participants were identified in the AoU program, with 53 % (n = 60,594) self-identifying as a racial or ethnic minority. Only 3575 participants (3.2 %) were documented as having received HPV vaccination. Median age of vaccination was 26 and participants ages 18-27 were more likely to be vaccinated. Participants without health insurance (OR = 0.32, 95 % CI 0.26-0.40), stable employment (OR = 0.85, 95 % CI 0.79-0.91), and those who reported lower income (OR = 0.87, 95 % CI 0.79-0.97) were significantly less likely to have received HPV vaccination. Participants who described cost as a barrier to healthcare were also less likely to have received HPV vaccination (OR = 0.82, 95 % CI 0.73-0.93). CONCLUSION: Sociodemographic factors including low income, lack of health insurance, and lack of stable employment were all associated with lower likelihood of catch-up HPV vaccination among adult women living in the United States.

Triple-Negative Papillary Carcinoma of the Breast: A Case Report.

Papillary carcinoma is a rare form of breast malignancy, representing only a small percentage of newly diagnosed breast cancers. Bloody nipple discharge is the most consistent symptom reported among patients. These lesions are visualized histologically as fibrovascular cores lined with proliferating neoplastic epithelial cells. Papillary breast carcinomas are characterized by estrogen receptor (ER), progesterone receptor (PR), and/or human epidermal growth factor receptor 2 (HER2) positivity, allowing for targeted therapeutic approaches with favorable outcomes. Triple-negative papillary carcinoma (TNPC) is a rare variant that lacks this characteristic hormone receptor expression, creating a unique challenge in diagnosis and management. Here, we highlight the case of a 43-year-old asymptomatic female with TNPC following an abnormal screening mammogram that revealed a suspicious mass in the left breast. Surgical excision with clear margins remains the cornerstone of treatment, with adjuvant chemotherapy considered for high-risk cases. As there is limited evidence on the efficacy of targeted therapies and hormone-based treatments, this case analyzes the diagnostic criteria, therapeutic options, and prognosis of TNPC to prompt further investigation into specific treatment strategies.

Knowledge, Attitude and Practice Concerning Cervical Cancer Screening Among Reproductive Age Group Women in Low-Resource Settings Yenagoa Bayelsa State.

Background: Nigeria has one of the highest rates of cervical cancer morbidity and mortality in Sub-Saharan Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive measures. Cervical cancer is the second most diagnosed cancer and the third leading cause of cancer death in women worldwide. Eighty three percent (83%) of the world's new cases and 85% of all cervical cancer-related deaths occur in developing countries. It is primarily caused by human papilloma virus (HPV); a sexually transmitted pathogen that could be prevented with safe sexual practice and using vaccines, among others. The aim of the study was to assess the knowledge and attitude of reproductive age group women in low resource setting in towards cervical cancer and its prevention in Yenagoa, Bayelsa State Nigeria. Methodology: This study employed the use of a descriptive study design to examine the knowledge and assessment of cervical cancer among women of reproductive age (19-54), about cervical cancer, its prevention, and their utilization of Pap smear screening; using a convenience sample of 406 women in two communities (Okaka and Agudama) in Yenagoa Local Government Area of Bayelsa State, Nigeria. Women voluntarily completed a structured questionnaire. Result: Results showed that women who participated in the study were aware of cervical cancer (78.3%; n=318) but many (70.4%; n= 286) were unaware of Pap smears as the screening tests for cervical cancer. Although few of them (45.6%; n =185) knew about a screening center, out of which 17.6% (n= 32) reported that the screening center was less than 2km away from their residences. Conclusion: There is need for health care professionals, to intensify efforts to increase awareness about cervical cancer screening and encourage women through the different clinics to use these services. The benefits of screening and early diagnosis of cervical cancer should be emphasized to enhance the utilization of cervical cancer screening services.

Molecular Detection by Rolling Circle Amplification Combined with Deep Sequencing of Mixed Infection by Bovine Papillomaviruses 2 and 4 in Carcinoma In Situ of the Bovine Esophageal Mucosa.

Papillomaviruses (PVs) are oncogenic and infect the skin and mucosa of various host species. Considering the recent advances in research on PVs using rolling circle amplification (RCA) followed by high-throughput sequencing (HTS), in this study, we aimed to investigate the bovine papillomavirus (BPV) types associated with proliferative lesions in the upper alimentary tract of an affected bull and characterize the viral strains through complete genome sequencing using this strategy. We analyzed the PV strains associated with two hyperplastic esophageal lesions through PCR using degenerate primer pairs and RCA, followed by HTS. HTS of the libraries generated using RCA products provided the whole genome sequence of BPV4 present in squamous papilloma, whereas the complete genome sequence of BPV2 and subgenomic fragments of BPV4 were identified in carcinoma in situ (CIS). For the first time, we have sequenced BPV2 identified from the CIS of the bovine upper alimentary canal. Additionally, RCA followed by HTS allowed characterization of the mixed infection by BPV2 and BPV4 in this lesion. These data reveal that BPV4 is not the only BPV type present in CIS of the esophageal mucous membrane; moreover, a mixed infection caused by BPV2 and BPV4 at the tested anatomical site was demonstrated.

A Case of Sinonasal Inverted Papilloma Suspected as Postoperative Recurrence of Eosinophilic Chronic Rhinosinusitis.

Chronic rhinosinusitis (CRS) is a persistent inflammatory disease affecting the nasal and paranasal sinus tissues, classified into two main categories: one associated with nasal polyps (CRSwNP) and one without them (CRSsNP). A particular form of CRSwNP, known as eosinophilic CRS (ECRS), is distinguished by the excessive presence of eosinophils in the affected tissues. While surgical intervention and corticosteroids are the standard treatments, high relapse rates have led to increasing interest in biological treatments. Inverted papilloma (IP), a benign yet recurrent tumor with potential for malignancy, often complicates diagnosis when concurrent inflammation is present. We present a case of a 56-year-old man with a long-standing history of ECRS, initially suspected to have experienced a recurrence. Imaging suggested the possibility of IP, but biopsy results showed a marked increase in eosinophil levels. Following surgery, the diagnosis of IP was confirmed, and no malignancy was found. A year after surgery, the patient remained free of recurrence. This case emphasizes the difficulty of differentiating ECRS from IP due to their overlapping histological features. To ensure accurate diagnosis, a thorough evaluation combining radiological, endoscopic, and pathological methods is crucial.

A case of squamous cell carcinoma of the lung misdiagnosed as tuberculosis. Is HPV infected by oral sex the causative agent?

BACKGROUND: The integration of high-risk human papilloma virus (HPV) DNA into the human genome has been implicated in cervical carcinogenesis and head and neck squamous cell cancer. However, its role in lung squamous cell carcinoma is not well understood. In addition, tuberculosis (TB) and lung cancer(LC) share similar clinical symptoms and imaging features, increasing the risk of misdiagnosis. CASE PRESENTATION: The patient presented with a 16-month history of hemoptysis, chest pain, and occasional fatigue, without fever, chills, or history of mechanical damage or autoimmune diseases. Examination revealed normal vital signs and laboratory parameters, except for a positive interferon-gamma release assay indicating tuberculosis infection. Bronchoscopic examinations identified congestion and edema of the tracheal wall, along with a tiny lesion in the right wall of the trachea. She had been misdiagnosed with tuberculosis. However, the diagnosis of squamous cell carcinoma was eventually confirmed by endoscopic biopsy. The patient's macrogenomic second-generation sequencing (mNGS) of the bronchoscopic biopsy specimen was positive for HPV-16.The patient's sex partner tested positive for HPV-16 in penile scrapings, indicating HPV transmission through oral sex. CONCLUSIONS: This case highlights the potential for HPV infection acquired through oral sex to lead to lung squamous cell carcinoma. It emphasizes the importance of considering HPV-associated malignancies in patients with respiratory symptoms who engage in oral sexual behaviors.

Synergistic pairing of synthetic image generation with disease classification modeling permits rapid digital classification tool development.

Machine-learning disease classification models have the potential to support diagnosis of various diseases. Pairing classification models with synthetic image generation may overcome barriers to developing classification models and permit their use in numerous contexts. Using 10 images of penises with human papilloma virus (HPV)-related disease, we trained a denoising diffusion probabilistic model. Combined with text-to-image generation, we produced 630 synthetic images, of which 500 were deemed plausible by expert clinicians. We used those images to train a Vision Transformer model. We assessed the model's performance on clinical images of HPV-related disease (n = 70), diseases other than HPV (n = 70), and non-diseased images (n = 70), calculating recall, precision, F1-score, and Area Under the Receiver Operating Characteristics Curve (AUC). The model correctly classified 64 of 70 images of HPV-related disease, with a recall of 91.4% (95% CI 82.3%-96.8%). The precision of the model for HPV-related disease was 95.5% (95% CI 87.5%-99.1%), and the F1-score was 93.4%. The AUC for HPV-related disease was 0.99 (95% CI 0.98-1.0). Overall, the HPV-related disease classification model demonstrated excellent performance on clinical images, which was trained exclusively using synthetic images.

The effect of digital storytelling on women's human papilloma virus awareness: Randomized controlled experimental study.

OBJECTIVE: This study aims to determine the effectiveness of the digital storytelling (DS) method in increasing human papilloma virus (HPV) awareness. STUDY DESIGN: The study was conducted in the gynecology and obstetrics outpatient clinic of a state hospital between April and December 2023. The universe of the study consisted of women who applied to the outpatient clinic between these dates and volunteered. A total of 80 women who met the inclusion criteria were included in the study (n = 40 for each group). Data for the study were gathered using Personal Introduction Form and Human Papilloma Virus Knowledge Scale. Repeated measures ANOVA method was used to determine the difference between the pre-training, post-first training and post-second training measurement scores according to the intervention and control groups. For significant ANOVA results, measurements with differences were compared pairwise using Bonferroni correction. All statistical analyses were examined at the p < 0.05 significance level. RESULTS: Socio-demographic characteristics and HPV awareness levels of women in the intervention and control groups were similar before training (p > 0.05). After the activity conducted with the digital story method in the intervention group, the HPV awareness levels of women in this group increased significantly (p < 0.05). Considering the development in each group, an increase in posttest scores is observed in both groups. However, when the increase amounts in each group in the intervention and control groups were examined, it was determined that all awareness levels increased more in the intervention group. In the intergroup comparison, it was determined that the mean measurements of general HPV knowledge, general HPV vaccine knowledge, and knowledge of the current HPV vaccination program of women in the intervention group at the first and second follow-ups after the training were higher than those in the control group. CONCLUSION: The DS method was effective in raising HPV awareness given to the intervention group. Health professionals and researchers can benefit from DS in providing health education and consultancy services such as HPV awareness.

Risk Factors for Recurrence after Surgical Resection of Sinonasal Inverted Papilloma.

Introduction Sinonasal inverted papilloma (SNIP) is a rare benign epithelial tumor of the nasal cavity and paranasal sinuses that accounts for 0.4% and 4.7% respectively, of all tumors of this anatomical region. Objective To analyze the outcomes after surgical resection of SNIP and identify the risk factors for recurrence in a Swiss tertiary center. Methods We conducted a retrospective review of all cases of SNIP treated at the Lausanne university hospital between 2005 and 2018. All data available on the patients and tumors were collected for analysis. We studied the recurrence rate and looked for risk factors. Results We included 57 patients with a mean age of 55.5 years. There were 46 primary cases (80.7%) and 11 recurrences (19.3%). Maxillary sinus was the most frequent location (33.3%). Approximately half of the patients (52.6%) presented with a T3 tumor according to the Krouse classification. The mean recurrence rate after surgery was of 17.5% and it was more frequent among the patients in the recurrence group (45.5%) than among the primary cases (10.9%), reaching statistical significance (odds ratio [OR] = 6.8; 95% confidence interval [95%CI]: 1.5-30.8; p = 0.0165). Most patients were treated endoscopically (94.7%). Frontal sinus location, higher Krouse stage, and combined approach seemed to increase the risk of recurrence, but without statistical significance. Conclusion Difficult surgical access, as in the case of tumors located in the frontal sinus, higher stage of the disease, and previously operated cases carry the higher risk of incomplete resection and recurrence.

Male and female human papilloma virus infection and assisted reproductive technology outcomes: A comprehensive assessment from prevalence in semen to obstetric outcomes.

Infertility, affecting approximately 16% of the global population, has led to increased reliance on reproductive medicine. The impact of human papillomavirus (HPV) infection in one or both partners on outcomes of Assisted Reproduction Technologies (ART) remains unclear. This prospective cohort study aimed to evaluate prevalence and effects of HPV infection in subjects and couples candidates to ART. A total of n = 510 men and n = 246 women were included and n = 145 couples (n = 290 individuals) had both partners enrolled in the study. The HPV semen infection rate was 17% (95% CI: 14-20) with HPV-42, HPV-16, HPV-53 and HPV-51 as the most frequently detected genotypes. In women, 26% (95% CI: 21-32) tested HPV-positive in cervical swabs. In 6% (95% CI: 3-11) of the couples, both partners were positive but only three couples shared the same genotypes (HPV-16; HPV-39, HPV-51, and HPV-42; HPV-31). Follicular fluids were positive in 20% (95% CI: 11-33) of samples, showing genotype discrepancies with cervical tests. Semen treatment could not completely eliminate the virus in positive samples but reduced the positivity to one-third. No significant differences in semen and embryological variables, clinical pregnancy and live birth rates, neonatal and obstetrics outcomes were observed in subjects with positivity in semen or cervix compared to respective negative groups. Cumulative live birth rates per oocyte retrieval in couples where both partners were negative or both were positive did not differ, being 37% (95% CI: 28%-47%) and 44% (95% CI: 19-73), respectively. In conclusion, HPV testing should not be considered a prerequisite for accessing ART treatments. Robust inferences for natural fertility cannot be made using our findings, as the ART setting does not fully reflect natural conditions.

Evaluating the efficacy and safety of intralesional bevacizumab in the treatment of recurrent respiratory papillomatosis: A systematic review.

PURPOSE: Recurrent respiratory papillomatosis (RRP) represents a clinical challenge, often necessitating multiple interventions to help mitigate against disease recurrence or airway obstruction. Multiple management strategies have been advocated by specialists regarding the management of RRP. However, the success rates and disease progression still vary widely. One promising treatment is bevacizumab, a vascular endothelial growth factor (VEGF) monoclonal antibody, which had been initially introduced systemically. More recently, intralesional bevacizumab has become one of the newest arms in dealing with RRP. The aim of this study is to systematically review the literature on the effectiveness, applicability and usage of intralesional bevacizumab in the treatment of RRP. METHODS: A systematic search was carried out on MEDLINE, Embase, Journals@Ovid and PubMed. PRISMA guidelines were adhered to in the reporting of this study. Study quality and bias risk was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: 6 studies have met our inclusion and exclusion criteria, one randomised doubled blinded placebo-controlled pilot study, one case series, three prospective and one retrospective study, encompassing a total of 108 patients. Anatomical, functional and objective outcomes are presented and scrutinised. Where reported, complete remission or minimal recurrence was identified in 34/38 (89 %) patients following treatment with intralesional bevacizumab. However, outcome measures were not consistent across all studies making it difficult to draw direct comparisons. Of the 6 studies, 2 (33 %) were deemed poor quality and 4 (66 %) fair quality. No adverse effects of intralesional bevacizumab were reported. CONCLUSIONS: This study's findings suggest a potential role for intralesional bevacizumab in the management of RRP objectively and functionally. Further research is required to necessitate a stronger evidence base, paying close attention to dose optimisation, assessment of long-term side effects and management of less severe disease phenotypes.

Prevalence of human papilloma virus infection and risk of cervical intraepithelial neoplasia among female sex workers in Mumbai, India.

Introduction: Cervical cancer, mostly caused by human papilloma virus (HPV), has disproportionately high incidence in developing countries. HPV infection being essentially a sexually transmitted infection, high-risk behaviour women with multiple sexual contacts like female sex workers (FSWs) are at higher risk of co-infection with HPV and of developing cervical precancer and cancer. Objective: This study aimed to determine the prevalence and determinants of HPV infection and cervical intraepithelial neoplasia (CIN) among FSWs in Mumbai, India. Methods: A cross-sectional study was conducted among 448 FSWs, between the ages of 18-50 years, by collaborating with local non-government organizations working for the health and welfare of FSW communities at sexually transmitted diseases clinics. All FSWs were screened for HPV DNA by hybrid capture II followed by reference diagnosis of colposcopy and/or cervical biopsy. Results: The prevalence of HPV DNA positivity was 35.5% and CIN was 2.2%. Factors significantly associated with HPV DNA positivity were age group younger than 30 years odds ratio (OR = 2.098, 95% confidence interval (CI) 1.408-3.127), Illiteracy (OR = 2.015, 95% CI 1.305-3.112), being single (OR = 2.409, 95% CI 1.558-3.724), less than 18 years of age at time of initiating work as FSW (OR = 3.718, 95% CI 3.718-2.392), having more than five clients per day (OR = 2.078, 95% CI 1.301-3.318), been working as a FSW for more than 5 years (OR = 2.321, 95% CI 1.455-3.701), not using barrier contraception methods (OR = 5.155, 95% CI 3.395-7.827) and having no exposure to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) education program (OR = 29.153, 95% CI 15.385-55.240). FSWs with a positive HPV DNA test are substantially more likely to have CIN compared to those with a negative test (OR = 7.6, 95% CI 1.59-36.25). Conclusion: The prevalence of HPV infection and CIN was high among FSWs. FSWs with a positive HPV DNA test had a seven times higher risk of developing CIN. The persistence of HPV infection is expected to significantly raise the risk of cervical cancer in the future. It is suggested to have an integrated approach towards cervical cancer screening and HIV/AIDS control activities.

Including the voice of children <15-years-old in paediatric global health research.

Purpose of Review: Despite evidence of the benefits of including children's voices in global health research, they continue to be underrepresented. Implementation of how to include children's voices appears to remain an obstacle to their inclusion in global health research. In this manuscript, we present an epistemological frame that advocates children as experts of their own experiences and knowledge-bearers. Then we provide four case studies, to illustrate ongoing efforts to build equity in the design and execution of paediatric health research. Recent Findings: Ensuring children's equitable inclusion requires recognizing them as active participants in their health and wellbeing, and empowering them to employ their agency in all interactions with researchers, while recognizing the dialogical nature of those interactions. Successfully involving children in global health research can lead to important psychosocial and clinical insights, that could be leveraged to inform future treatment and care practices. Summary: We present four case studies describing the inclusion of children in research and research development related to prevention, treatment and/or care of chronic and acute diseases (tuberculosis, HIV, cervical and other forms of cancer) in a number of global settings including India, Philippines, South Africa, United States, Zambia. The exemplars detail novel applications of a diversity of arts-based methods that are rooted in frameworks for participatory action research. They highlight the need to invest funds, training, time and resources for early and sustained engagement with children throughout the research process. We conclude by offering principles for equitably engaging children in global health research.

Management of frontal sinus and frontal recess inverted papilloma: our experience and systematic review.

Objective: For frontal sinus inverted papilloma (FSIP) management, an endoscopic endonasal approach (EEA) can be combined (or not) with an external approach by an osteoplastic flap (OPF) or with a more conservative open approach. The present study aims to describe our experience in the management of FSIP, focusing on disease-related and anatomical features influencing outcomes and recurrence. Methods: This case series of FSIP investigated anatomical and disease-related predictors of recurrence associated with EEA or a combined EEA-OPF approach. A systematic review was also performed, selecting publications on IP with the insertion point in the frontal sinus or frontal recess. Results: Among 30 patients included, 18 underwent EEA, while 12 received a combined EEA-OPF approach. During a median follow-up of 37 months, the frontal sinus was cleared of IP in all cases except 2 in the EEA group, who presented a complex posterior wall shape of the frontal sinus. From the systematic review, a combined EEA-OPF approach was associated with a lower risk of recurrence. Conclusions: A correct indication for a combined EEA-OPF approach is paramount and should integrate all disease-related and anatomical features, including posterior wall shape.

Factors related to cervical cancer and human papilloma virus awareness among rural women of southern Bangladesh: A cross-sectional study.

Introduction: Cervical cancer is an important public health issue in Bangladesh. Despite government efforts, the awareness and healthcare utilization in rural areas are inadequate. Methodology: This cross-sectional study was conducted in six districts of Barishal division over 997 respondents aged 15-64 years. The demographic variables, accessibility to healthcare, vaccination status, awareness of HPV causing cervical cancer, and knowledge of the HPV vaccine were recorded through a structured questionnaire. T-test for univariate and chi-square test for bi-variate analysis were used. Logistic regression was used to determine factors associated with awareness. Results: Most of the participants were SSC passed (45.3%), unemployed (54.4%), and married (74.4%). While 83.5% were aware of cervical cancer, only 3.3% knew about HPV's role. The majority (96.2%) had never been tested for HPV, albeit 79.5% knew about the vaccine, and only 2.45% were vaccinated. Knowledge levels were low, with only 1.4% demonstrating sound knowledge, mostly associating with higher income, residing closer to healthcare facilities, and being married. Bhola district participants had highest level of awareness, and the lowest was in Pirojpur. Education level was positively correlated with knowledge, with graduates being most aware. Logistic regression showed education, marital status, willingness to vaccinate daughters, and district were significantly related with better awareness, while income, distance, and age did not. Conclusion: Mass education and awareness campaigns may improve the awareness level in rural community.

Efficacy of photodynamic therapy for oral multifocal papilloma: a case report.

Oral papilloma, a frequently encountered benign lesion, can be managed effectively with various treatments. A unique case of oral mucosal papilloma extending from the buccal fat pad region to the corner of the mouth is presented here. Although papilloma larger than 10 mm2 are associated with a high risk of becoming cancerous and should be treated promptly, the papilloma in this case would have been difficult to resect due to involvement of the parotid duct opening and the corner of the mouth. Topical external application of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) was employed successfully in this case, with no recurrence at 20 months of follow-up. Therefore, ALA-PDT may represent a promising therapeutic option for challenging cases of multifocal papilloma of the oral mucosal.

Study of Knowledge, Attitudes, Acceptability and Preference of Home-based HPV Self-Sampling Among a Population of Moroccan Women.

In Morocco, cervical cancer screening rate is still low, which determines the need to adopt new screening approaches. Vaginal self-sampling for HPV testing is one of these strategies. Anticipating changes in screening plans for CC, we would like to present to health authorities a global view about the acceptability and preference of vaginal self-sampling for HPV testing among a population of Moroccan women. The aim of this pilot study is to assess the acceptability and preference of vaginal self-sampling for HPV testing among a population of Moroccan women. A cross-sectional study surveyed 400 Moroccan women aged between 25 and 65 years, who are recruited from various healthcare facilities in three Moroccan regions, between March and November 2022. Data were collected via interviews, using a questionnaire. Among the 400 participants, 380 (95%) were ready to undergo a vaginal self-sampling for HPV testing. Among participants who expressed their willingness to perform this test, 295 (73.6%) prefer to carry out it at home. A decreased likelihood of HPV self-sampling was determined by belief that only women with vaginal discharge or bleeding need to be screened. Age, marital status, perceived severity of CC, practice CC screening, and perceived self-efficacy were identified as the main factors influencing the preference for home based vaginal self-sampling for HPV testing. Vaginal self-sampling for HPV testing is an alternative option that could overcome a set of screening barriers defined in the Moroccan context, in order to increase CC screening coverage.

Digital Spatial Profiling identifies distinct patterns of immuno-oncology-related gene expression within oropharyngeal tumours in relation to HPV and p16 status.

Background: The incidence of oropharyngeal cancer (OPC) is increasing, due mainly to a rise in Human Papilloma Virus (HPV)-mediated disease. HPV-mediated OPC has significantly better prognosis compared with HPV-negative OPC, stimulating interest in treatment de-intensification approaches to reduce long-term sequelae. Routine clinical testing frequently utilises immunohistochemistry to detect upregulation of p16 as a surrogate marker of HPV-mediation. However, this does not detect discordant p16-/HPV+ cases and incorrectly assigns p16+/HPV- cases, which, given their inferior prognosis compared to p16+/HPV+, may have important clinical implications. The biology underlying poorer prognosis of p16/HPV discordant OPC requires exploration. Methods: GeoMx digital spatial profiling was used to compare the expression patterns of selected immuno-oncology-related genes/gene families (n=73) within the tumour and stromal compartments of formalin-fixed, paraffin-embedded OPC tumour tissues (n=12) representing the three subgroups, p16+/HPV+, p16+/HPV- and p16-/HPV-. Results: Keratin (multi KRT) and HIF1A, a key regulator of hypoxia adaptation, were upregulated in both p16+/HPV- and p16-/HPV- tumours relative to p16+/HPV+. Several genes associated with tumour cell proliferation and survival (CCND1, AKT1 and CD44) were more highly expressed in p16-/HPV- tumours relative to p16+/HPV+. Conversely, multiple genes with potential roles in anti-tumour immune responses (immune cell recruitment/trafficking, antigen processing and presentation), such as CXCL9, CXCL10, ITGB2, PSMB10, CD74, HLA-DRB and B2M, were more highly expressed in the tumour and stromal compartments of p16+/HPV+ OPC versus p16-/HPV- and p16+/HPV-. CXCL9 was the only gene showing significant differential expression between p16+/HPV- and p16-/HPV- tumours being upregulated within the stromal compartment of the former. Conclusions: In terms of immune-oncology-related gene expression, discordant p16+/HPV- OPCs are much more closely aligned with p16-/HPV-OPCs and quite distinct from p16+/HPV+ tumours. This is consistent with previously described prognostic patterns (p16+/HPV+ >> p16+/HPV- > p16-/HPV-) and underlines the need for dual p16 and HPV testing to guide clinical decision making.