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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.