Lack of Correlation Between Human Papillomavirus and Nasopharyngeal Cancer: A Comprehensive Assessment Through Systematic Meta-Analysis

Objectives: Decoding the involvement of human papillomavirus (HPV) in nasopharyngeal cancer (NPC) has yielded contradictory findings worldwide. Despite various statistical meta-analyses exploring this association, controversy persists due to inherent limitations of meta-analysis. In this study, we aimed to investigate the potential link between HPV and NPC using an alternative method, the Bradford Hill criteria, to provide a clearer perspective. Methods: PubMed was utilized to extract studies associating HPV with NPC. We evaluated the potential association using the Bradford Hill criteria postulates, scrutinizing available data on HPV in NPC and normal/benign samples. Rigorous assessment of study methodologies enhanced the authenticity of our findings, considering the possibility of false-negative and false-positive results. Results: A comprehensive evaluation against Bradford Hill criteria revealed unfulfilled major postulates, including strength, temporality, consistency, plausibility, biological gradient, experiment, specificity, and analogy. Conclusion: Our findings suggest no causal association between HPV and NPC.