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Human papillomavirus (HPV) infection is a distinct risk factor for oropharyngeal squamous cell carcinoma (OPSCC), and HPV 16 is associated with most HPV-OPSCC cases.
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Incidence rate of HPV-OPSCC, particularly tonsillar cancer, has been rapidly increasing for the past 2 decades, whereas tobacco-related head and neck squamous cell carcinoma rates are decreasing worldwide.
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Typical patients with HPV-OPSCC are described as men, white, younger than 60, healthier individuals with no or little tobacco
Human Papillomavirus and Oropharyngeal Cancer
Section snippets
Key points
Human papillomavirus–associated head and neck squamous cell carcinoma: epidemiology and clinical characteristics
HPV is a small (8-kb), nonenveloped circular DNA virus with epithelial tropism.13 The HPV family comprises approximately 200 viral strains with more than 40 being transmitted through direct contact with the skin and mucous membranes.13, 14 To this end, HPV infection is the most common sexually transmitted disease in the United States. According to the Centers for Disease Control and Prevention (CDC), approximately 20 million Americans are currently infected with HPV with 6 million newly
High-risk human papillomavirus infection and pathogenesis
The likelihood of detecting high-risk HPV in OPSCC has been reported as higher than in healthy normal mucosa.2, 8, 14 However, the mechanisms through which high-risk HPV infection contributes to carcinogenesis remain under active investigation. The reticulated crypt epithelium of the lingual and palatine tonsils strongly expresses programmed cell death-1 ligand 1 (PD1-L1). PD1-L1 suppresses the T-cell response to HPV, thereby creating an “immune-privileged” site for infection and adaptive
Human papillomavirus–associated oropharyngeal squamous cell carcinoma: diagnosis and treatment
For accurate diagnosis of HPV-OPSCC, the importance of thorough history-taking and physical examination, along with appropriate imaging, cannot be overemphasized.12 An enlarged lateral neck mass may be noticed in asymptomatic patients, which often indicates metastasis to the lateral cervical lymph node. This occurs commonly in OPSCC because of its relatively late detection. As the tumor progresses, symptoms such as dysphasia or tonsillar pain may present. Precancerous lesions may not be easily
Future strategies in prevention of human papillomavirus-associated head and neck squamous cell carcinoma
The link between oral sex behavior and oropharyngeal HPV infection is evident. Strong association between orogenital contact and OPSCC was found in a hospital-based, case-control study of 100 newly diagnosed OPSCC patients and 200 controls.45 A recent systematic review in 2014 found 50% to 80% of adolescents and young adults reported participation in oral sex.46 Such widespread oral sexual practices among the young may be contributing to the rapid increase of OPSCC. To reduce HPV transmission,
Summary
HPV-OPSCC is now recognized as a distinct subtype of HNSCC, and its recent increase in incidence is an emerging public health problem. This article reviewed the current understanding of HPV-OPSCC. Although the pathogenesis by which HPV infection in OPSCC remains incompletely understood, further investigations are necessary to reduce the global burden of OPSCC.
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Disclosure Statement: The authors have no commercial or financial conflicts of interest and no funding sources to disclose.