Background:
Recent trends in the incidence of squamous cell carcinoma in head and neck region have been reported despite the decreasing rate of drinking and smoking. Squamous cell carcinoma of skin is the leaking cause of the skin malignancies. Human papillomavirus (HPV) has been discovered in head and neck cancer tissues and blood specimens. However, the association between HPV infection and skin cancers remains unclear.

Material and Methods:
This population-based cohort study was conducted using data from Taiwan's single-payer national health insurance and cancer registry databases. Data on HPV infection, cancer, sex, age, comorbidities, urbanization, and occupation were collected. The cumulative incidence rates were generated using Kaplan–Meier curves and log-rank tests. COX regression analysis was used to estimate the hazard ratios of factors associated with cancer occurrence. We used data from 2007 and 2017. The cases were matched with sex and age in a 1:2 manner with 939874 HPV+ and 1,879,748 HPV– individuals, respectively.

Results:
The adjusted hazard ratios [95% confidence interval (CI)] for HPV infection in all skin cancers were 5.222 (4.700–5.802), male skin cancer 1.215 (1.102–1.340), female skin cancer as reference). The highest adjusted hazard ratio for skin cancer was HPV infection 5.222 (4.700–5.802) , followed by hypertension 1.261 (1.123–1.417), and male sex 1.215 (1.102–1.340). The all cumulative incidence rates in skin carcinoma, squamous cell carcinoma, basal cell carcinoma, other carcinoma and melanoma of HPV infection are higher significantly than those of Non-HPV infection.

Conclusion:
Our study showed that HPV infection was highly associated with the occurrence of the skin cancers in both men and women but was not associated with types of skin malignancies.

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