Head and Neck Cancer and Human Papilloma Virus

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Head and Neck Cancer and Human Papilloma Virus

Head and neck cancer is a serious issue that is impacting many patients worldwide. The incident of head and neck cancer is 640,000 new cases a year. Based on 2013 data from the National Cancer Institute, 41,380 new cases are in the U.S., and that number has been steadily rising since then. Only 50% of these patients are going to survive their cancer in five years. Historically the death rate is particularly high not because it is hard to discover or diagnose but due to the cancer being routinely discovered late. An early stage tumor five-year survival rate is higher than 95%.

Incident of head and neck cancer is only three percent of all cancers. Males are usually affected more than females. That incident was 10 1 in the past but that gap has decreased to 3 1, likely due to the increase of prevalence of smoking in females and increase in the prevalence of the Human Papilloma Virus (HPV).

The most common cancer in the head and neck (about 98% of head and neck cancers) is squamous cell carcinoma. Squamous cell carcinoma travels through the lymphatic channels so any spread in the body will start by a spread in the lymphatic system in the neck. Any other cancers in the head and neck include, but are not limited to cancers of the salivary glands and facial skeleton.

Head and neck cancer used to be considered a disease of the elderly who have a history of tobacco and alcohol abuse, but lately it has been increasing in incidence in the younger population for patients under 40 years of age. This is thought to be related to the increased prevalence of HPV.

Oral cancer and pre-cancerous lesions could appear in many forms a white patch, red patch, non-healing ulceration, ear pain or unexplained neck swelling.

The main modality for treatment of oral cancer is mainly surgery, which could be supplemented by radiotherapy and chemotherapy when indicated.

Human Papilloma Virus is one of the most common viruses in the world and it usually affects mucosal layers. There are 120 types of Human Papilloma Viruses and only a few have a tendency to cause oral or pharyngeal cancer. About 15-20% of oral cancers and about 60% of pharyngeal cancers are positive for HPV.

Patients with tumors that test positive for HPV are usually non-smokers, non-drinkers, with good oral hygiene and younger than 45 years of age. Patients with HPV do have a better prognosis and response to cancer treatment, radiation and chemotherapy.

In conclusion it is recommended that each patient regardless of age undergo a comprehensive head and neck exam whenever he/she follows up with his/her general dentist for their regular hygiene visits and be referred to the oral surgeon for further evaluation for any suspicious lesion.