2. The Emerging Role of HPV in Head and Neck Cancer
Author: PhD Thomas E. Carey
Publisher: Springer International Publishing
Head and neck squamous cell carcinoma accounts for 90 % of the tumors that arise in the head and neck region. These have long been considered to be a disease of older men in their 60s and 70s that are associated with heavy use of tobacco and alcohol. As smoking became more prevalent among women in the 1940s and 1950s, more women were affected by this cancer type. However, in the past 20 years as fewer people smoke, there has been a slow decline in the incidence of larynx cancer, but at the same time, there has been an increase in the incidence of cancers of the palatine tonsil and base of tongue. This has been accompanied by a shift in the demographics with an increase in the frequency of younger people, mostly men in their 40s and 50s, presenting with oropharyngeal cancers. Remarkably, these younger patients also report a much lower frequency of tobacco use, suggesting that a different etiology was a factor for these cancers. Many studies have now implicated high-risk human papillomaviruses, notably HPV16 and HPV18, but also other types in the etiology of oropharyngeal as well as some nasopharyngeal, oral, and laryngeal cancers. In this chapter we will summarize the background for papillomavirus carcinogenicity, the discovery of HPV in head and neck cancers, and the current status of their role in the etiology and response to therapy.