HPV Linked To Head and Neck Cancers

You’ve probably seen the ads for the new vaccine that protects young women against infection with human papillomavirus (HPV) and the promise the vaccine holds for preventing most types of cervical cancer.

There’s another devastating form of cancer linked to HPV infection — head and neck cancer — and almost no one is talking about it.

“I think the public and most physicians have no idea that HPV relates to head and neck cancer,” said Wendell Yarbrough, M.D., Vanderbilt-Ingram Cancer Center surgical oncologist. “In cancers of the oropharynx, which includes the tonsils, the base of the tongue, and part of the throat, about half of those tumors are HPV-positive. In the oral cavity, between 10 and 15 percent of tumors test positive for HPV, although here at Vanderbilt-Ingram we’re seeing up to 20 percent.”

HPV is one of the most common sexually transmitted diseases in the world. The Centers for Disease Control and Prevention (CDC) estimates nearly 6.2 million new genital HPV cases occur in the United States each year. Now researchers have documented a rise in some types of head and neck cancer related to HPV. The spike coincides with reported changes in sexual habits among young people, including earlier age of sexual activity and an increase in oral sex.

The good news is that patients whose tumors are HPV-positive may do better than those whose cancers are HPV-negative. In fact, in a study of patients with cancer of the oropharynx, those whose tumors were HPV-positive had higher rates of response to treatment and lower risks of cancer progression and death than those whose cancers were HPV-negative, reported Anthony Cmelak, M.D., a Vanderbilt radiation oncologist, along with colleagues from Johns Hopkins Medicine, Dana Farber Cancer Institute, Stanford University and Fox Chase Cancer Center.

There are more than 100 subtypes of HPV. Types 16 and 18 usually are implicated in cervical cancer and are found in HPV-positive head and neck cancers. The HPV vaccine is effective against those subtypes but the vaccine is only approved for use in girls and women ages 9 to 26.

The discovery of a link between the virus and head and neck cancer raises the possibility of vaccinating young men, Yarbrough said.

– by Dagny Stuart