Recent data linking human papillomavirus with oropharyngeal cancers, which typically occur in men, suggest a need for stepped-up efforts to gain approval for use of the HPV vaccine in young men and adolescent boys, according to Dr. Erich Sturgis and Dr. Paul M. Cinciripini, of the University of Texas M.D. Anderson Cancer Center, Houston.
Although the incidence of most types of squamous cell carcinomas of the head and neck have declined over the past 20 years, in tandem with declines in the prevalence of smoking, the incidence of oropharyngeal cancers has remained stagnant—a trend that may be attributable to the growing incidence of oncogenic HPV-associated cancers, the authors wrote (Cancer 2007 Oct. [doi:10.1002/cncr.22963]).
They praised efforts to promote the recently approved HPV-16/18 vaccination of young women and adolescent girls to reduce the incidence of cervical cancer and dysplasia, but warned that limiting vaccination programs to females would delay potential benefits of preventing the HPV-16/18 oropharyngeal cancers in males.
Dr. Cinciripini has acted as a consultant for GlaxoSmithKline, the manufacturer of Cervarix, a vaccine against HPV 16/18.
Data have shown an increase in the incidence of oral tongue cancer in young adults and of oropharyngeal cancers, particularly tonsil and base of tongue cancer, in those younger than 45 years. In addition, the literature consistently shows a link between oncogenic HPV and oropharyngeal cancers, with HPV DNA being identified in about half of all oropharyngeal cancers and in a particularly high proportion of oropharyngeal cancers in nonsmokers. More than 90% of HPV-positive oropharyngeal cancers are a result of HPV-16.
The similarities between HPV-related oropharyngeal cancer and cervical carcinogenesis, and the “biologic plausibility of the HPV carcinogenesis model all support HPV causality of a proportion of oropharyngeal cancers,” they noted.
The mode of transmission of HPV in patients with HPV-related oropharyngeal cancer is not clear, but some reports suggest the sexual history of oncogenic HPV-positive oropharyngeal cancer patients mirrors that of women with cervical cancer, and it is likely that risk factors such as multiple sexual partners and oral-genital sex play a role, the authors said.