Opinion statement
Oropharyngeal cancer has demonstrated a steady increase in incidence over the past 20 years in contrast to declining numbers of head and neck squamous cell carcinoma (HNSCC) overall. Recent evidence has found that high-risk strains of human papillomavirus (HPV) are the likely cause of the changing epidemiology of oropharyngeal cancer. HPV-associated oropharyngeal cancer has a molecular, epidemiological, and clinical profile that is distinct from non-HPV HNSCC. Clinicians managing oropharyngeal HNSCC need to be aware of differences in the HPV HNSCC population which may impact treatment outcomes. Testing of HNSCC tumor tissue for HPV using validated and precise techniques should be performed when feasible.
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Ferlay J, Bray F, Pisani P, Parkin DM: Globocan 2002: Cancer Incidence and Mortality Worldwide. IARC Cancer Base No. 5, Version 2.0. Lyon, France: IARC; 2004
Sheinin R: Viruses: causative agents of cancer. Laryngoscope 1975, 85:468–486
Lindeberg H, Fey SJ, Ottosen PD, Mose Larsen P: Human papilloma virus (HPV) and carcinomas of the head and neck. Clin Otolaryngol Allied Sci 1988, 13:447–454
Brandwein MS, Nuovo GS, Biller H: Analysis of prevalence of human papillomavirus in laryngeal carcinomas. Study of 40 cases using polymerase chain reaction and consensus primers. Ann Otol Rhinol Laryngol 1993, 102:309–313
Park NH, Min BM, Li SL, et al.: Immortalization of normal oral human keratinocytes with type 16 human papillomavirus. Carcinogenesis 1991, 12:1627–1631
Schiffman M, Castle PE, Jeronimo J, et al.: Human papillomavirus and cervical cancer. Lancet 2007, 370:890–907
Doorbar J: Molecular biology of human papillomavirus infection and cervical cancer. Clin Sci 2006, 110:525–541
Mork J, Lie K, Glattre E, et al.: Human papillomavirus infection as a risk factor for squamous-cell carcinoma of the head and neck. N Engl J Med 2001, 344:1125–1131
Herrero R, Castellsague X, Pawlita M, et al.: Human papillomavirus and oral cancer: the International Agency for Research on Cancer Multicenter Study. J Natl Can Inst 2003, 95:1772–1783
Kreimer AR, Clifford GM, Boyle P, Franceschi S: Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiol Biomarkers Prev 2005, 14:467–475
Begum S, Cao D, Gillison M, et al.: Tissue distribution of human papillomavirus 16 DNA integration in patients with tonsillar carcinoma. Clin Cancer Res 2005, 11:5694–5699
Califano J, van der Reit P, Westra W, et al.: Genetc progression model for head and neck cancer: implications for field cancerization. Cancer Res 1996, 56:2488–2492
Weinberger PM, Yu Z, Haffty BG, et al.: Molecular classification identifies a subset of human papillomavirus-associated oropharyngeal cancers with favorable prognosis. J Clin Oncol 2006, 24:736–747
Rose BR, Li W, O’Brien CJ: Human papillomvirus: a cause of some head and neck cances? Med J Aust 2004, 181:415–416
Shiboski CH, Schmidt BL, Jordan RC: Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20–44 years. Cancer 2005, 103:1843–1849
Sturgis EM, Cinciripini PM: Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer 2007, 110:1429–1435
Hammarstedt L, Lindquist D, Dahlstrand H, et al.: Human papillomavirus as a risk factor for the increase in incidence of tonsillar cancer. Int J Cancer 2006, 119:2620–2623
Anaya-Saavedra G, Ramirez-Amador V, Irigoyen-Camacho E, et al.: High association of human papillomavirus infection with oral cancer: a case–control study. Arch Med Res 2008, 39:189–197
Gillison ML, D’Souza G, Westra W, et al.: Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst 2008, 100:407–420
Psyrri A, DiMaio D: Human papillomavirus in cervical and head-and-neck cancer. Nature Clin Prac 2008, 5:24–31
Goldenberg D, Begum S, Westra WH, et al.: Cystic lymph node metastasis in patients with head and neck cancer: an HPV-associated phenomenon. Head Neck 2008, 30:898–903
Fakhry C, Westra W, Li S, et al.: Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 2008, 100:261–269
Nichols AC, Faquin WC, Westra WH, et al.: HPV-16 infection predicts treatment outcome in oropharyngeal squamous cell carcinoma. Otolaryngol Head Neck Surg 2009, 140:228–234
Klozar J, Kratochvil V, Salakova M, et al.: HPV status and regional metastasis in the prognosis of oral and oropharyngeal cancer. Eur Arch Otorhinolaryngol 2007, 20: Epub ahead of print
Ragin CCR, Taioli E: Survival of squamous cell carcinoma of the head and neck in relation to human papillomavirus infection: review and meta-analysis. Int J Cancer 2007, 121:1813–1820
Settle K, Posner MR, Schumaker LM, et al.: Racial survival disparity in head and neck cancer results from low prevalence of human papillomavirus infection in black oropharyngeal cancer patients. Cancer Prev Res 2009, 2:OF1–6
Licitra L, Perrone F, Bossi P, et al.: High-risk human papillomavirus affects prognosis in patients with surgically treated oropharyngeal squamous cell carcinoma. J Clin Oncil 2006, 24:5630–5636
Hafkamp HC, Manni JJ, Haesevoets A, et al.: Marked differences in survival rates between smokers and nonsmokers and HPV 16-associated tonsillar carcinomas. Int J Cancer 2008, 122:2656–2664
Westra WH, Taube JM, Poeta ML, et al.: Inverse relationship between human papillomavirus-16 infection and disruptive p53 gene mutations in squamous cell carcinoma of the head and neck. Clin Cancer Res 2008, 14:366–369
Pradier O, Christiansen H, Schmidberger H, et al.: Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phy 2005, 63:1368–1377
Begum S, Gillison ML, Ansari-Lari MA, et al.: Detection of human papillomavirus in cervical lymph nodes: a highly effective strategy for localizing site of tumor origin. Clin Cancer Res 2003, 9:6469–6475
Roh JL, Kim JS, Lee JH, et al.: Utility of combined (18)F-fluorodeoxyglucose-positron emission tomography and computed tomography in patients with cervical metastases from unknown primary tumors. Oral Oncol 2009, 45:218–224
Koch WM, Bhatti N, Williams MF, Eisele DW: Oncologic rationale for bilateral tonsillectomy in head and neck squamous cell carcinoma of unknown primary source. Otolaryngol Head Neck Surg 2001, 124:331–333
Miller CS, Johnstone BM: Human papillomavirus as a risk factor for oral squamous cell carcinoma: a meta-analysis, 1982–1997. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001, 91:622–635
Smith EM, Swarnavel S, Ritchie JM, et al.: Prevalence of human papillomavirus in the oral cavity/oropharynx in a large population of children and adolescents. Pediatr Infect Dis J 2007, 26:836–840
Giuliano AR, Harris R, Sedjo RL, et al.: Incidence, prevalence, and clearance of type-specific human papillomavirus infections: the Young Women’s Health Study. J Infect Dis 2002, 186:462–469
Giuliano AR, Lu B, Nielson CM, et al.: Age-specific prevalence, incidence, and duration of human papillomavirus infections in a cohort of 290 US men. J Infet Dis 2008, 198:827–835
Garland SM, Hernandez-Avila M, Wheeler CM, et al.: Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med 2007, 356:1928–1943
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Gillespie, M.B., Rubinchik, S., Hoel, B. et al. Human Papillomavirus and Oropharyngeal Cancer: What You Need to Know in 2009. Curr. Treat. Options in Oncol. 10, 296–307 (2009). https://doi.org/10.1007/s11864-009-0113-5
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DOI: https://doi.org/10.1007/s11864-009-0113-5