HPV IN ORAL SQUAMOUS CELL CARCINOMA - CHANGING TRENDS IN THE RISK FACTORS AND DEMOGRAPHICS OF ORAL CANCER IN THE INDIAN SUBCONTINENT

Abstract

<h3>Background</h3> Human papilloma virus (HPV) is a double-stranded DNA virus that infects the epithelial cells of skin and mucosa. It is established now that sexual contacts, both conventional and oral, are means of transferring HPV through direct skin-to-skin contact. A small number of oral cavity cancers are related to HPV infection that may not be due to oral habits. <h3>Objective</h3> To review the existing literature on the association of HPV and oral cancer and to highlight the uniqueness of their clinical presentation and histopathologic appearance. <h3>Methods</h3> A literature search was undertaken, and all relevant data were collected where an association of HPV and oral cancer was established. The focus was on studies involving an Indian population where known risk factors were not present in oropharyngeal cancers. <h3>Results</h3> Several studies reveal the characteristic clinical presentation of oropharyngeal cancer without known etiologic factors such as tobacco smoking or chewing and use of betel nut with or without additives. Women of younger age groups are more likely to fall into this category. HPV of high-risk strains has been isolated from the affected tissues, and a certain uniqueness is observed in the microscopic features of such HPV-associated oral cancers. <h3>Conclusions</h3> The prototypical patient with oral cancer is no longer an elderly man with the habit of smoking or chewing tobacco or betel nut and/or drinking alcohol for many years. HPV is emerging as a powerful risk factor and is increasingly recognized as a subgroup of oral squamous cell carcinoma with a distinct biological and clinical profile.