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ACP News August 16, 2013

Prevention of HPV-associated Oropharyngeal Cancers

According to the statement from the American Dental Association, while oral and pharyngeal cancers related to tobacco and alcohol use have decreased, oropharyngeal cancers associated with HPV infection increased 225 percent from 1988 through 2004. Therefore, it's encouraging that a recent study conducted to evaluate the effectiveness of the vaccine Cervarix for preventing cervical cancer was also found to be 93 percent effective in preventing HPV types 16 and 18 oral infections.

The outcome reported by the study was the prevalence of oral HPV infection and not cancer diagnosis. However, it seems likely that preventing certain types of HPV infections will prevent HPV-associated oropharyngeal cancer. Read the ADA review and commentary on the study.

HPV infection is a validated risk factor for oropharyngeal cancer in both men and women, even in the absence of smoking and alcohol use. In its statement on HPV cancers of the oropharynx, the ADA Council on Scientific Affairs recommends that clinicians conduct thorough hard- and soft-tissue examinations, including the lymph nodes, and educate patients about the relationship between HPV and oropharyngeal cancer.

The incidence of HPV-associated oropharyngeal cancer is four times higher among men than women, higher among younger adults (especially white males aged 40-59 years) and among persons with a higher lifetime number of sex partners (vaginal and oral). Most people infected with HPV will never develop HPV-associated cancers.

The ACP has resources for practitioners about HPV and oral cancer, such as this Oral Cancer Screening Exam on YouTube and Oral Cancer Screening Brochures, as well as information for patients on prosthodontics.org. Further information can be found on MouthHealthy.org, the ADA's website for patients.

 

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