From the Guidelines
Oropharyngeal cancers are a distinct entity of head and neck cancers, primarily caused by human papillomavirus (HPV) infection, with a significant increase in incidence in recent decades.
Key Characteristics
- HPV-positive oropharyngeal cancers are associated with younger age, male sex, and a history of oral and vaginal sexual partners 1
- HPV-negative oropharyngeal cancers are often linked to tobacco and alcohol consumption 1
- The incidence of HPV-positive oropharyngeal cancer is forecasted to exceed that of cervical cancer by 2020 1
Epidemiology
- The prevalence of HPV-positive tumors in the oropharynx has steadily increased, while the prevalence of HPV-negative oropharynx cancers has declined 1
- HPV subtype 16 is estimated to be present in the oropharynx of 1% of sexually active adults at any given time and is responsible for over 70% of new cases of oropharyngeal HNSCC 1
Prognosis and Treatment
- HPV-positive oropharyngeal cancers have a better prognosis compared to HPV-negative tumors 1
- Currently, there is insufficient data to recommend less-intense treatment for patients with HPV-positive oropharyngeal cancers compared to those with HPV-negative cancers 1
From the Research
Definition and Overview of Oropharyngeal Cancers
- Oropharyngeal cancers, specifically oropharyngeal squamous cell carcinoma (OPSCC), are a type of cancer that has been increasingly associated with human papillomavirus (HPV) infection 2, 3, 4, 5.
- The incidence of oropharyngeal cancer has escalated in recent decades, largely triggered by high-risk HPV 3, 4.
- Oropharyngeal carcinomas are distinct from other head and neck carcinomas due to their increasing frequency and frequent association with HPV infection 6.
Characteristics and Prognosis
- HPV-positive (HPV+) oropharyngeal squamous cell carcinoma has a better prognosis compared to its HPV-negative (HPV-) counterpart 2, 5.
- The clinical profile of patients with HPV-associated oropharyngeal cancer differs from that of traditional head and neck cancer patients, with a significantly better prognosis 5.
- Early stages of oropharyngeal cancer may be treated with single modality treatment, resulting in high five-year overall survival rates, while advanced stages require therapeutic associations and have lower survival rates 6.
Detection and Prevention
- There is a need for early detection and prevention of oropharyngeal cancer, as it is often detected at an advanced stage due to a lack of symptoms in the early stages 2, 3, 4.
- Biomarkers that identify individuals at high risk for oropharyngeal cancer may act as surrogate markers for precancer, but these are limited and more research is needed to identify premalignant lesions 3.
- The HPV vaccine has shown efficacy and safety in preventing oral HPV infections, providing an opportunity for prevention of HPV-related oropharyngeal cancer 4.