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Objective: The causative and prognostic roles of human papillomavirus (HPV) in non-oropharyngeal squamous cell carcinoma of the head and neck are uncertain. This umbrella review assessed the strength and quality of evidence and graded the evidence derived from published meta-analyses on this subject. Data sources: MEDLINE, Embase, and the Cochrane Library were searched. Meta-analyses of observational studies and randomized trials were included. Review methods: Evidence of association was graded according to the established criteria: strong, highly suggestive, suggestive, weak, or not significant. Results: 15 meta-analyses were evaluated. The association with HPV was highly suggestive of oral (OR = 2.40, [1.87–3.07], P < 0.00001) and nasopharyngeal cancers (OR = 17.82 [11.20–28.35], P < 0.00001). Improved survival emerged only in hypopharyngeal carcinoma and was confirmed in studies in which only p16 + cancers were considered. Conclusion: HPV infection may increase the risk of oral cavity and nasopharyngeal cancer. However, the prognosis was not influenced, except in hypopharyngeal carcinoma. [ABSTRACT FROM AUTHOR]

Objectives: To prospectively assess prevalence/characteristics of clinically unsuspected pulmonary embolism (PE) in cancer patients undergoing follow-up chest MDCT and investigate MDCT protocol.Methods: We evaluated 1013 oncologic patients. MDCT images at 5 and 1.25 mm thickness were independently evaluated. Pulmonary artery opacification degree was assessed. Presence, level, and site of PE were reported. Type of malignancy and metastases were reported for PE-positive patients.Results: After excluding 1.4% (14/1013) of examinations due to inadequate vessel opacification, 999 patients (572 male; mean age:68 ± 12 years; range:26-93 years) entered the study. Prevalence of PE was 5%. There was significant improvement in the sensitivity for both readers in the evaluation of 1.25 mm compared to 5 mm images (46-50% to 82-92%). 30% (15/51) PE were not described by the radiologist in the prospectively issued report; 53 % (27/51) of PE were segmental, 72.5% (37/51) unilateral. The right lower lobe was the most involved (59%). 27% patients had colon cancer, 18% lung cancer. Among PE-positive patients (25 male; mean age 70 ± 10 years; range:44-87 years), 25% (13/51) had lung cancer, 15% (8/51) colon cancer.Conclusions: Thin reconstructions are essential for PE diagnosis, regardless of reader experience. Regarding oncologic patients, incidental PE diagnosis influences anticoagulation therapy.Key Points: • CT pulmonary angiography is the gold standard for PE diagnosis. • Cancer and oncological treatments are risk factors for PE. • The prevalence of unsuspected PE was 5%. • Thin reconstructions are essential for PE diagnosis regardless of reader experience. • In oncologic patients, PE diagnosis influences anticoagulation therapy. [ABSTRACT FROM AUTHOR]