Human Papillomavirus in Head and Neck Cancer: Several Questions

Abstract

Received April 14, 2013 Accepted May 14, 2013 Address for correspondence Yuh-S. Jung, MD, PhD Department of OtolaryngologyHead and Neck Surgery, Head and Neck Oncology Clinic, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea Tel +82-31-920-1685 Fax +82-31-920-1157 E-mail jysorl@ncc.re.kr The past decade has seen changes in the global trends for head and neck cancers in terms of incidence, etiologic and demographic patterns. Several case-control studies have consistently shown human papillomavirus (HPV) exposure dramatically increases the occurrence of oropharyngeal cancer. HPV related (+) oropharyngeal cancer has been found to be epidemiologically and clinically distinctive disease, characterized by younger age at onset, and strong association with reproductive behavior. The incidence of this disease is increasing sharply worldwide, whilst HPV negative (-) cancers are declining. HPV(+) cancers have significantly better survival and responses to chemoradiation, than HPV(-) counterparts. Given this superior survival, de-escalated therapies and organ preservation surgeries are being considered and on the clinical trial. Currently available prophylactic virus-like particle vaccines might be efficacious for primary prevention of HPV(+) cancers, although not validated yet. More researches are needed for the effective secondary prevention, through the deeper understanding of precancerous, molecular and pathologic changes. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(3):143-50