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Throat cancer surpasses cervical cancer as most common HPV-related cancer

Karmanos Cancer Institute
According to the CDC, throat cancers linked to HPV have increased significantly over the last 15 years in the United States.

Doctors have long known that the human papilloma virus (HPV) is linked to cervical cancer. However, many members of the public – and even members of the medical community – are not aware of the strong link between HPV and head and neck cancers.

Statistics from the Centers for Disease Control and Prevention (CDC) reveal almost 15,500 men and approximately 3,500 women were diagnosed with HPV-related throat cancer in 2015, according to Ammar Sukari, M.D., leader of the Head and Neck Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute and associate professor in the Department of Oncology at Wayne State University School of Medicine.

This increase means that oropharyngeal cancer (OPC), a type of throat cancer, has surpassed cervical cancer as the most prevalent HPV infection-related cancer. Now, oncologists are seeing cases of this cancer in mostly non-smokers, non-drinkers and younger white males in higher socioeconomic brackets due to HPV, according to Sukari.

What is HPV?

HPV is a human-only virus that can infect skin and mucosal membranes (such as those in the mouth or anus). HPV viruses are sexually transmitted and affect tens of millions of Americans every year. They are so prevalent that the CDC estimates that nearly every sexually active man and woman will be diagnosed with HPV sometime in their lives.

Nine out of 10 cases of mucosal HPV are eliminated by the immune system. However, in 10 percent of HPV infections, cells survive and lead to cancer over time. For example, an HPV infection at the base of the tongue could lead to tongue cancer 20 to 30 years after the initial infection.

According to the CDC, throat cancers linked to HPV have increased significantly over the last 15 years in the United States. Sukari accredits this increase to changes in sexual practices and greater awareness among doctors regarding the link between HPV and oropharyngeal cancer.

“The World Health Organization added HPV as a risk factor for oropharyngeal cancer approximately 15 years ago,” Sukari said. “Before that, doctors weren’t checking for this in their head and neck cancer patients.”

More to learn about HPV-related cancers

Although many doctors are now more aware of the link between HPV and head and neck cancers, Sukari says there’s more work needed to raise awareness. Because the field is changing so quickly, it is possible that the individuals teaching today’s medical students are not fully aware of the link between HPV and cancers of the head and neck.

In fact, Sukari calls HPV-related head and neck cancers a health crisis.

“The red light is flashing on this disease,” he said. “Everyone knows about cervical cancer and Pap tests, and fortunately, the incidence of cervical cancer has been on the decline for a long time. The same needs to be done to raise awareness about HPV and its link to oropharyngeal cancer. It is very common, and it is on the rise.”

What to look for, how to treat

Symptoms of HPV-related throat cancer (oropharyngeal) may include swollen lymph nodes in the neck, a lump or ulcer in the throat, difficulty swallowing and/or pain with swallowing.

Luckily, if it is caught early, HPV-related oropharyngeal cancer (HPV+ OPC) is very curable.

Karmanos is home to a head and neck cancer multidisciplinary team that focuses solely on cancers affecting these parts of the body. Additionally, Karmanos currently offers multiple clinical trials for those diagnosed with HPV-related oropharyngeal cancer. These treatments have been created explicitly for throat cancers resulting from HPV.

The trials have two goals in mind: increase the cure rate of these cancers and minimize long-term organ damage that may occur due to different treatment modalities needed to cure these cancers.

“There are a lot of new studies and clinical trials, so we have the ability to tailor treatments,” Sukari explained.

Sukari also strongly advocates for the HPV vaccine, also known as Gardasil®, which was first approved by the U.S. Food and Drug Administration (FDA) in 2006 to prevent cervical cancer linked to HPV. In 2018, the FDA approved a supplemental application for Gardasil 9, expanding the vaccine’s approved use to include women and men aged 27 through 45 years.

The vaccine can prevent both cervical cancer and oropharyngeal cancer, Sukari said. Still, there is a prevailing stigma about the vaccine.

“All those sexually transmitted diseases have a stigma around them, too,” he said. “Some doctors may not be comfortable discussing this with their patients or parents, in the case of pediatric practices. There is an urgent need to have a lot of work done on the part of schools, universities and public health professionals in educating the public about the HPV vaccine.”

And, for Sukari, it begins with the critical education – and generating awareness – about HPV-related cancers that can save lives.

For more information about HPV-related head and neck cancer treatments, participating in a clinical trial or scheduling an appointment, please call 1-800-527-6266 or visit Karmanos.org.

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