Rise in oropharyngeal cancers linked to HPV

Rates of oropharangeal cancer have increased by around 50 per cent in the last 20 years, according to a report in the British Medical Journal.

Researchers at the Institute of Head and Neck Studies and Education (InHANSE) at University Hospital, Coventry, suggest that the increase in this type of head and neck cancer could be caused by the transmission of the human papillomavirus (HPV) through oral sex.

According to the study authors, head and neck cancer is the sixth-most common form of cancer in the world, with approximately 640,000 people being diagnosed with the disease each year.

But while the overall incidence of head and neck cancer cases has shown a small decline in recent years, there has been a marked growth in the number of cases of oropharyngeal cancer.

Between 1989 and 2006, oropharyngeal cancer incidence rose by seven per 100,000 to 11 per 100,000 in UK men, which is equivalent to a 51 per cent increase.

Other recent research in Stockholm and the US has shown a proportional increase in the detection of HPV in tissue samples of oropharyngeal squamous cell carcinoma, suggesting that this may be playing a role in the rise.

People who develop this type of cancer are typically younger and employed. The study authors have raised concerns that the rise in cancer could have health service implications. They have also suggested it may be beneficial for the HPV vaccine to be given to boys as well as girls.

In an editorial accompanying the study, they said: “A recent modelling study of the effects of HPV vaccination in males concluded that routinely vaccinating boys for HPV could not be justified on health economic grounds.

“The recent rapid rise in HPV related oropharyngeal carcinoma may alter the cost effectiveness of vaccinating boys before they become sexually active.”

Nell Barrie, Cancer Research UK’s science information officer, said: “We know that HPV can cause oropharyngeal cancer, as well as several other types of cancer including cervical cancer. But although HPV infection is common, the virus causes cancer only in a minority of people. More research will be needed to determine if patients with HPV related head and neck cancer could benefit from different treatment, and to understand if any changes to health services are needed.

“It will also be interesting to see if the HPV vaccine could help to reduce rates of oropharyngeal cancer. The vaccine protects against cervical cancer by immunising women against the two most common cancer-causing types of HPV.”