Human Papillomavirus and Head and Neck Cancer
Human papillomaviruses (HPV) have been implicated in the pathogenesis of several cancers of the anogenital tract, including cervical, vulvar, vaginal, and anal cancers in women and penile and anal cancers among men. In 2007, the World Health Organization stated for the first time that there was sufficient molecular and epidemiological evidence to conclude that HPVs are also etiologic for a nonanogenital malignancy, specifically oral cancers  . HPV infection is necessary for the development of cervical carcinoma, where HPV genomic DNA is identified in virtually all cancers (>99%)  . By contrast, for all other HPV-associated malignancies inclusive of oral cancers, only a subset of cancers at that anatomic site is attributable to HPV [3, 4] . Taken together, an estimated 561,000 men and women worldwide were diagnosed with cancers attributable to HPV infection in 2002  , accounting for approximately 5.2% of the global cancer burden  . According to the Centers for Disease Control, approximately 20,000 cancers in the United States were attributable to HPV infection each year during the period from 1998 through 2003 [4, 7] . HPV infection is therefore a major cause of morbidity and mortality from cancers worldwide.
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