Among the human cancers associated with human papillomavirus (HPV) are several head and neck cancers, including oropharyngeal squamous cell carcinoma (OSCC) and oral cavity squamous cell carcinoma (OCSCC). The incidence of HPV-positive head and neck cancer has risen dramatically in men under age 50 years over the past 20 years. In the face of this fact, it is important to increase the awareness of the problem, encourage more research to better understand the pathogenesis of these cancers, and
Head and neck squamous cell cancers (HNSCCs) are the sixth leading malignancy worldwide and primarily affect the oral cavity, oropharynx, nasopharynx, larynx, and hypopharynx. Etiologic contributors include tobacco use and alcohol consumption. A decrease in these cancers has occurred in concert with a decline in tobacco usage, but OSCC of the tonsil and base of the tongue in particular has increased in incidence among men younger than age 50 years with no history of tobacco or alcohol usage.
The pathogenesis of HPV-associated HNSCC is believed to be similar to that of cervical cancer. Infection of the oral squamous epithelium with HPV results in either a productive life cycle or a transformative life cycle. The first is associated with progressive differentiation of the epithelial cells that culminates in virion generation and egress. The second results in transformation of the growth-arrested differentiated cells into actively proliferating cells. In the productive life cycle, the
No evidence indicates that the treatment of HPV-associated head and neck cancers differs from that for other cancers in this area. Patients with early-stage HPV-positive HNSCC can be managed with a single-modality treatment involving surgery or radiation and tend to have a favorable prognosis. Radiation is more common, but surgery is the best option in carefully selected patients. For example, carefully chosen early oropharyngeal cancers respond well to minimally invasive techniques such as
Urgent action is needed to raise public awareness about HPV-associated head and neck cancers and to undertake research on the pathogenesis of HPV-associated cancers and therapeutic strategies for managing them. Clinical Significance Although the oncogenicity of HPV in oral cancers is believed to be similar to that seen in cervical neoplasia, more information is needed to develop novel strategies to prevent and treat HPV-positive OSCC. Questions remain about the biology of HPV-associated OSCC,
Sathish N, Wang X, Yuan Y: Human papillomavirus (HPV)-associated oral cancers and treatment strategies. J Dent Res 93:29S-36S, 2014
Reprints available from Y Yuan, Dept of Microbiology, School of Dental Medicine, Univ of Pennsylvania, Philadelphia, PA 19104; e-mail: [email protected]
