Human Papilloma Virus-Induced Head and Neck Cancer

Head and neck cancers are a common spectrum of diseases, accounting for over one-third of a million deaths worldwide each year, and over 11,000 annual US deaths. This has typically been thought of as a disease related predominately to lifestyle choices, specifically to heavy exposures to tobacco and alcohol, and as such, has been diagnosed more in older males than in females. With increased public education efforts aimed at reducing smoking and moderating alcohol consumption, the incidence of many subgroups of head and neck cancer is now decreasing in the United States. However, over the past couple of decades, the demographics of at least a subset of head and neck cancer are radically shifting, with increases in the rate of predominantly oropharyngeal carcinomas in younger, nonsmoking, males. These lesions are caused by infections with the same high-risk human papillomaviruses (HPV) responsible for cervical cancer and other anogenital neoplasms. These HPV-induced head and neck cancers exhibit a different biology and prognosis from the “traditional” head and neck cancer. Learning the biology of these lesions is allowing for a better understanding of head and neck cancer in general, and will allow for the development of selective preventive and treatment strategies for this subpopulation of patients.