Although the overall incidence of head and neck cancers has declined in the United States, the rate of oropharyngeal cancers is stagnant overall and appears to be rising in men younger than 45 years, according to a review in the Oct. 1 issue of Cancer, a journal of the American Cancer Society.
Erich M. Sturgis, MD, MPH, and Paul Cinciripini, PhD, of The University of Texas M. D. Anderson Cancer Center, Houston, concluded that the stagnant incidence rates of oropharyngeal cancers, particularly cancers of the tonsil and the base of the tongue, in the face of declines in tobacco use—the principal cause of head and neck cancers—likely are explained by a rising prevalence of oropharyngeal exposure to an oncogenic virus.
The authors say the literature points to exposure to human papillomavirus (HPV), especially strain 16, as having the strongest association with oropharyngeal cancers.
Cancers of the head and neck, which include cancers of the larynx, nasal passages/nose, oral cavity, pharynx and salivary glands, account for 3 percent of all newly diagnosed cancers in the United States. Men are three times more likely than women to be diagnosed with these cancers.
Of the estimated 45,000 new cases of head and neck cancers expected this year, approximately 10,000 are cancers of the pharynx (chiefly the oropharynx). Though the prognosis for these cancers is excellent when they are caught early, more than one-half of them are identified in advanced stages when the prognosis is far worse, making prevention critical to saving lives.
The authors suggest that a recently approved HPV vaccine ultimately may have a significant impact on the incidence of oropharyngeal tumors.
They "encourage the rapid study of the efficacy and safety of these vaccines in males and, if successful, the recommendation of vaccination of young adult and adolescent males."
(The HPV vaccine also is used to prevent cervical cancer in girls and young women.)
