HPV & Oropharyngeal Cancer
听(CDC)听cites the human papilloma virus鈥HPV鈥as the most common sexually transmitted infection in the United States. The virus听spreads听through听intimate听sexual听contact, causing听infections that are so common, that 鈥渘early all men and women will get at least one type of HPV at some time in their lives.鈥澨听听
Most infections are asymptomatic, undetected and resolved by the body鈥檚 immune system.听Less commonly,听the infection听can be persistent,听progressing听to cancer in both women and men later in life.听听
HPV's connection to oropharyngeal cancers
Oropharyngeal cancer鈥cancer of the oropharynx, which includes听the听tongue, tongue-base, tonsils, and soft palett别鈥now听is听the most common cancer caused by HPV, having surpassed cervical cancer in incidence in 2015. It听is thought to cause 70%听or more听of oropharyngeal cancers in the United States.听听听
The game-changer听in听HPV听prevention came in 2006, when听the Food and听Drug听Association (FDA)听approved a vaccine called听骋补谤诲补蝉颈濒庐.听The FDA鈥檚听indications and recommendations for听eligible ages for the vaccine听(an updated version called Gardasil 9庐)听have听听over time, and now includes听both males and females up to age 45,听and听now with indication for preventing听HPV-associated head and neck cancer,听in addition to听the听prior anogenital indications.听听
Causes of听oropharyngeal cancers
鈥淭丑e landscape of cancers of the oropharynx has shifted dramatically in the last 20 or 30 years,鈥 says Andrew听Tassler, MD,听assistant professor of otolaryngology, Weill Cornell Medical College, and assistant attending otolaryngologist,听NewYork-Presbyterian Hospital.听听
The听majority of oropharyngeal听cancers seen at that time听were听associated听more with tobacco and alcohol consumption,听not听related听to HPV,听Dr.听Tassler听said.听
鈥淭丑ere听has basically been a听flip in the epidemiology听鈥攊n my practice now, probably 80 to 90 percent of听oropharyngeal cancers are听HPV related,鈥 he says, adding that the typical patient with this type of cancer is male, Caucasian, and between the ages of 55听to 65, with minimal exposure to alcohol and tobacco.听Dr. Tassler estimates that听10 to 20 percent of the oropharyngeal cancer patients he sees are women.听
Minimizing transmission and risks
In addition to receiving the Gardasil 9庐听vaccine,听the听听using听condoms and dental dams consistently and听properly听during oral sex,听which may help lower the chances of听transmitting听or听contracting听HPV.听
Although there is no specific screening for听oropharyngeal听cancer,听like something akin to a pap smear to detect cervical cancer,听Dr. Tassler听says some patients may听experience听symptoms,听including a lump听in the neck or throat,听difficulty swallowing or听painful swallowing, and听possibly change in their voice.听听can include trouble breathing or speaking; a feeling that something is caught in the throat;听or听throat pain that won鈥檛 go away.听
鈥淕enerally speaking,听patients who present with听HPV-associated听oropharyngeal cancers听do quite well, and their condition is usually highly treatable and curable,鈥 Dr.听Tassler听says.听鈥The five-year survival rate is 90-plus percent听for the majority of patients, he adds鈥攁nd the HPV vaccine听adds听long-term optimism听to the picture.鈥听
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