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Tuesday, October 19, 2010

Human papillomavirus (HPV) is now the main cause of head and neck cancer in the USA


There is a continuous increase in oropharyngeal squamous cell carcinoma (OSCC), due to Human papiloma virus (HPV) that accounts for over half of the new cases. HPV (most commonly type 16) was found in 45% to 100% of OSCCs in various studies. Most patients are in individuals younger than 50 years, are Caucasians, males that are non alcohol consumers and non smokers. The cancer associated with HPV is mostly oral, tongue and tonsils. New data suggests that changes in sexual practices are behind the surge in OSCC cases linked to sexually transmitted HPV. The key factors appear to be multiple sex partners, starting sexual activity at a younger age, and practicing oral sex.

According to the CDC about half of all sexually active Americans will get HPV at some point in their lives. In the US, oral cancer due to HPV infection is now more common than oral cancer from tobacco use, which is still the main cause of such cancers in the rest of the world. Scientists found a 225-percent increase in oral cancer cases in the US from 1974 to 2007, mostly among white men.  The single greatest factor associated with the cancer  is the number of partners on whom the person has performed oral sex. Individuals who had performed oral sex on six or more partners over a lifetime face an eight-fold higher risk of acquiring HPV-related head or neck cancer than those with less than six partners.

While HPV cancer growth more rapidly it is easier to treat than non-HPV cancer and patient with HPV positive cancer have a lower risk of dying compared to those with HPV-negative cancer. These patients may need less radiation and chemotherapy to get better which means that they will have less side effects. However, studies that explore these issues are ongoing and there is not yet a consensus whether less treatment is best for these patients. A review of recent epidemiological studies can be found on this site.

There is promising research that may enable one day to treat those with HPV associated cancer by vaccinating them. Preliminary studies in animals show vaccination in conjunction with chemotherapy to be effective against the cancer.

It is yet unknown if the introduction of HPV vaccination during adolescence in boys and girls that was mainly done to reduce cervical cancer in women will decrease the rate of this cancer. It is possible now to find out if the cancer is caused by HPV or not which was not the case until recently.

All these new developments hold promise for better treatments in the future.
The CDC has informative site on HPV.



6 comments:

  1. This comment has been removed by a blog administrator.

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  2. I'm glad you went to that symposium Dr Brook and I wish I'd been there too to hear first-hand the latest information and views on this very important topic. Thanks for posting your easy to read and understand summary of the main important information presented at the symposium :)

    There's a very good article on the Oral Cancer Foundation website http://oralcancer.org mentioned by Aalix above, on the page http://oralcancer.org/hpv/index.htm . It includes an embedded 11 minute podcast produced by Johns Hopkins Medicine, which can also be accessed on its original web page http://www.hopkinsmedicine.org/news/audio/podcasts/GillisonPod.html?sms_ss=email&at_xt=4cdeb6620f8568f5,0. It's one of the best media items on research into the link between hpv and oral cancer I've found.

    An important scientific paper on this subject, titled "Oropharyngeal cancer epidemic and human papillomavirus", is reproduced on the website of the Oral Cancer Foundation, on this page: http://oralcancernews.org/wp/oropharyngeal-cancer-epidemic-and-human-papillomavirus/ Nov 7, 2010, Source: www.foodconsumer.org, Authors: Torbjörn Ramqvist and Tina Dalianis.

    One of the first questions people are bound to ask (particularly young people) is "Can kissing transfer the hpv bug?". I haven't been able to find any definitive research on that topic and wondered if it was discussed at the symposium.

    Another aspect of concern is that many people who are diagnosed as having a head and neck cancer caused by hpv are going to feel some self-blame and guilts about their past sexual activities. I very much hope that all of us working in the field or supporting people with cancer can help to minimize any such negative feelings and encourage people not to go down that thought-path! Logically it's not the adventurous sex that's the problem it's the fact that there happens to be cancer-causing hpv strains widespread in the human population that are transferred by oral and other sexual activities that's the problem.

    Let's hope that the present vaccines or new versions that immunize against the relevant cervical cancer hpv strains for girls and young women will prove effective in immunizing boys and men against the hpv too.

    Cheers - Ed.

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  3. congratulations Itzhak for publishing information re the HPV link to Head and Neck cancer.You too Ed - there is much information available re the link between HPV and Head and Neck cancers.Just use Google - terrifying results !
    I raised the subject on a forum twice - and twice it was deemed "unnacceptable" .
    It led to arguments and eventually all discussion of it was banned - an entire generation deprived of information which could save their lives.
    It grieves me that people will die through sheer ignorance - we ought to be spreading the word of HPV as a cancer cause far and wide.
    People (mostly in the older age group ) find it just too embarrassing to talk about the subject let alone pass the word on to the new generation who are now being affected.
    Here in the U.K. a programme of vaccination for teenage girls is in full flow - to be extended to include boys within the next 2 years.Only by acknowledging thefacts can we stop the spread of HPV - very well done and thank you.

    Christine

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  4. I also tried to post the information on WebWhispers and was denied. I agree that this information should be disseminated so that more people would get vaccinated and use "safe sex"

    I Brook MD

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  5. christineprice990@btinternet.comDecember 7, 2010 at 11:58 AM

    It`s no good Itzhak - they won`t listen .

    I have just written to them asking why they have suddenly introduced this rule that states that people may not attach a web or blog site when signing letters to the mail list - as you do.
    Result - a letter from Michael Caspo saying he has asked the BOD to rescind my membership of WW.

    I am absolutely heartbroken - I have fought the Laryngectomees cause for 12 years now and mentored on both Laryngectomy Life and WW .

    I am not a techie person - and I know many others on WW are not either - I could just click on your link by your signature and get right here - WHY they want to withdraw this defeats me.

    Still I can pop on via fb now - but their attitude has puzzled and upset me .

    Keep playing the music and preaching the word !
    I have told all of my children and granchildren of the link to HPV - they can look at Grandad`s stoma and think - ??I wonder? no -I will not take the risk !

    They in turn have told friends - in this way the word will eventually get all around the world.

    Christine

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  6. Hopefully more people with get the message & get anything out of the ordinary checked out. There should be no shame with having HPV as the source, once you have it you do & to here that the treatments work & can be intensive w/o HPV people will focus on treatment not past sexual history.

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