Human Papillomavirus-Associated Head and Neck Cancer

Article Figures & Data

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Figure 1.
SEER Age-Adjusted Trends in Oral Cavity and Pharynx Cancer, 1975 to 2017.¹ Results from cancer incidence data from population-based cancer registries covering approximately 34.6% of the US population.
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Figure 2.
Human Papillomavirus (HPV) Prevalence Among Patients With Oropharyngeal Cancer as Reported in A Systematic Review and Meta-Analysis of Studies Published Between 1966 and 2010.⁷

Table 1.

Proposed HPV Screening Tools¹²

Screening Tool	Concept	Limitation
Oral HPV screening	Sample patient's saliva and test for high-risk HPV viral DNA	Although this can detect the presence of HPV DNA, the majority of individuals will go on to clear the virus without progressing to carcinoma
HPV serology	Asses serum levels of antibodies to high-risk HPV strands	Serum antibody levels represent the cumulative exposure to HPV but are not specific to exposure at a particular anatomic site (oropharynx, cervix, etc.) and do not reflect expression of HPV-related oncoproteins E6 and E7, which are necessary for carcinogenesis
Transcervical ultrasound	Ultrasound of the head and neck can be used to assess individuals with neck masses or those who are found to be at high risk via other screening methods. It may help detect small tumors in earlier stages and improve morbidity	Although ultrasound is relatively inexpensive and can be done quickly in the office, it is not practical for universal screening and relies on either the symptom of a neck mass or other screening method to prescreen high-risk individuals
Mucosal imaging	Direct visualization of subclinical lesions via endoscopy	There are no identifiable premalignant lesions, and as with the limitations of ultrasound, there needs to be a prescreening method to identify high-risk individuals before subjecting them to this more invasive procedure. Additionally, many of these tumors arise from tonsillar crypts and cannot be easily identified on surface-level examination