Table 1.

Proposed HPV Screening Tools12

Screening ToolConceptLimitation
Oral HPV screeningSample patient's saliva and test for high-risk HPV viral DNAAlthough this can detect the presence of HPV DNA, the majority of individuals will go on to clear the virus without progressing to carcinoma
HPV serologyAsses serum levels of antibodies to high-risk HPV strandsSerum 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 ultrasoundUltrasound 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 morbidityAlthough 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 imagingDirect visualization of subclinical lesions via endoscopyThere 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
  • HPV, Human papillomavirus; DNA, Deoxyribonucleic acid.