HPV-16 in Oral Cavity Associated With Increased Risk of Oropharyngeal Squamous Cell Carcinoma

“This study is important because it provides the first evidence that detection of HPV16 preceded the diagnosis of head and neck cancers, suggesting the possibility of early detection of lesions. In addition, the detection of unsuspected skin HPV types, such as beta- and gamma-HPVs, as risk factors opens up a whole new area of investigation. We do not know the natural history of cancer related to these types of HPV,” Dr Agalliu told Cancer Therapy Advisor. “Furthermore, if confirmed in additional studies it could provide the basis for consideration of including other HPV types in the vaccine for prevention.”

He said these new findings could have public health implications in the future for both HPV screening and future development of vaccines that could target beta and gamma HPVs in addition to HPV16 for preventing head and neck cancers.

The associations between oral HPV infection and HNSCC were adjusted for smoking status, pack-years, and number of alcoholic drinks per week. These are all established risk factors for HNSCC.

However, in an accompanying editorial Rollison and colleagues wrote assessment of the time-dependent exposure of tobacco smoking at baseline and every 1 to 2 years relative to the mouthwash sample collection for HPV detection is not clear.²

Questions also remain over whether underlying immune or genetic factors may be contributing to the development of HNSCC.

Jose Zevallos, MD, who is an assistant professor and director of oncologic research in the Department of Otolaryngology/Head and Neck Surgery and adjunct assistant professor in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, said this is an important study that further supported the growing role of HPV infection in oropharyngeal cancer.

“It also further emphasizes the need for HPV vaccination for children, adolescents, and young adults. The association between beta and gamma HPV types and head and neck cancer requires further research, and if validated in larger studies, has the potential to lead to new vaccines. It should be noted that the currently available vaccines, if widely implemented, already have the potential to be effective against the majority of HPV-associated head and neck cancers,” Dr Zevallos told Cancer Therapy Advisor.

References

1. Agalliu I, Gapstur S, Chen Z, et al. Associations of oralα-, β- , and γ-human papillomavirus types with risk of incident head and neck cancer [published online ahead of print January 21, 2016]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.5504
2. Rollison DE, Gillison ML. The alpha, beta, gammas of oral human papillomavirus infection and head and neck cancer risk [published online ahead of print January 21, 2016]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.5686.