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Head and Neck Cancers Rise in Young Men

HPV-associated head and neck cancers are more prevalent

Kerstin Stenson, MD

By Nancy DiFiore

Head and neck cancers, while still considered rare, are striking younger men at a higher and more rapid rate. And many of the patients do not have the typical cancer risk factors: smoking, chewing tobacco or consuming alcohol.

Instead, infection with human papillomavirus 16, commonly known as HPV, is now thought to cause more than half of all cases of oropharyngeal cancer, a type of head and neck cancer.

“The head and neck cancers we have found in younger men with no known risk factors such as smoking are very frequently associated with the same HPV virus that causes cervical cancer in women," says Kerstin Stenson, MD, a head and neck cancer surgeon at Rush and a professor of otolaryngology at Rush University.

The cancer develops from an HPV infection, likely acquired years earlier during oral sex with a female partner infected with HPV.

"Men are more susceptible to these cancers because they don’t seem to have the same immune response as women and do not shed the virus like women do,” Stenson explains.

'Epidemic proportions'

According to the Centers for Disease Control and Prevention, cancers of the oropharynx (back of the throat, including the base of the tongue and tonsils) are usually caused by tobacco and alcohol, but recent studies show that about 72 percent of oropharyngeal cancers are caused by HPV.

“There has been significant change in the last decade. The HPV-associated oropharyngeal cancer has reached epidemic proportions,” Stenson warns.

The American Cancer Society estimates that 45,780 Americans will be diagnosed with cancer of the oral cavity and oropharynx in 2015.

If this trend continues, the number of cases of HPV-positive oropharyngeal cancer will surpass the number of cervical cancer cases.

Early detection is key

The HPV vaccine currently in use has been shown to decrease the incidence of cervical infections and cancer associated with the virus. While the same result is anticipated for HPV-associated head and neck cancer, the impact of vaccines on incidence of persistent oral HPV infection and/or HPV associated oropharyngeal cancer has not yet been investigated. Still, head and neck surgeons, medical oncologists and other researchers strongly advocate vaccination of both girls and boys to help prevent all HPV-associated cancers.

“For all individuals, the key is in early detection, as with any cancer,” Stenson observes.

In addition to being vaccinated, Stenson stresses the importance of regular visits to the dentist. “Dentists play a key role in detecting oral cancer," she says. "You might not see a primary care physician even once a year, but most people see their dentist twice a year. Having regular dental visits can  help catch cancers early to help ensure the best outcome.”

The American Dental Association states that 60 percent of the U.S. population sees a dentist every year.

Oral cancer warning signs

The Oral Cancer Foundation presumes that cancer screenings of the existing patient population would yield tens of thousands of opportunities to catch oral cancer in its early stages.

Possible warning signs of oral cancer may include difficulty swallowing, pain when chewing, a white patch anywhere on the inside of your mouth, a lump or sore in the mouth or on the lip that does not heal. If you notice any of these symptoms, ask your dentist or doctor about it.

Treatment includes surgery for early or low-volume late stage lesions and radiation or chemoradiation for more advanced cancers.

“There is much that can be done for those who are diagnosed with head and neck cancer.  Since early detection and treatment is critical, it's important to see your dentist regularly and to promptly see a medical professional if there are any warnings signs,” Stenson advises.

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