HPV-associated oropharyngeal cancer awareness and prevention

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Human papillomavirus (HPV)-associated oropharyngeal cancer awareness and prevention is a vital concept from a public and community health perspective.

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HPV is the sexually transmitted virus that is known to be the cause of genital warts. There are currently more than 100 different strains of HPV, half of which can cause genital infections. [1] Although it is not usually the HPV strains that cause genital warts associated with the oropharyngeal cancers, they have transmitted the same way through oral-genital sexual contact, and consumers should protect themselves accordingly and adhere to routine health and dental screening schedule to monitor and maintain their health status. [2] Many people with HPV do not develop any symptoms but can still infect others through sexual contact. Symptoms may include warts on the genitals or surrounding skin. There's no cure for the virus and warts may go away on their own. Treatment focuses on removing the warts. A vaccine that prevents infection with the HPV strains most likely to cause genital warts and cervical cancer is recommended for boys and girls.[ citation needed ]

Detection

Learning and utilizing self-examinations of your body, checking for changes or abnormalities in your mouth while performing your oral hygiene as well as routine checks of your genitals after showering can enhance your awareness of changes in your health status. According to the Centers for Disease Control and Prevention (CDC), most sexually active people are likely to acquire at least one HPV infection in their lifetime. [2] It is important that consumers seek routine dental examinations as a part of their health care to allow screening of this type of cancer, as early detection can mean all the difference in treatments. Oral cavity and oropharyngeal cancers can occur anywhere in the mouth but occur most often in the tongue, tonsils, oropharynx (back of the throat), gums, and the floor of the mouth. [3] According to the U.S. Preventative Services Task Force, "Oropharyngeal cancer is difficult to visualize and is usually located at the base of the tongue (the back third of the tongue), the soft palate (the back part of the roof of the mouth), the tonsils, and the side and back walls of the throat" [4] and requires a thorough examination by a dental provider or preferably a specialist. Men are twice as likely as women to have oral cancer, regardless of race, as African-Americans and Caucasians are equally likely to develop oral cancer. [3]

Cancer

Many people do not realize that some cancers can be linked to viral illnesses like an HPV infection. Oropharyngeal cancer has been linked in some cases to HPV. The most common type (indicated in about 90%) of oral and oropharyngeal cancer is squamous cell carcinoma. [5] Approximately 63% of oropharyngeal squamous cell carcinomas each year are associated with HPV infection. [1] Most cases of HPV go undetected and clear up on their own without the patient ever knowing they had contracted it. [1] [2]

There are 13 HPV strains that are known to potentially cause cancer. [6] According to the CDC, during an analysis of reported data from national cancer and epidemiological registries between 2008 and 2012, of 30,700 cases of cancer estimated to be caused by HPV, 24,600 (9500 oropharyngeal) were found to be caused by strains HPV 16 and HPV 18 (which are preventable through vaccination) and 3,800 (900 oropharyngeal) were found to be caused by 5 other preventable strains. [6]

Prevention

Vaccination is recommended for females and males alike, as early as age 9 and up to 26 years of age. [7] Pre-teens can get their HPV vaccination at the same time as other scheduled vaccinations and boosters for convenience, as they can be safely administered together. Parents should speak to their child's paediatrician regarding their recommendations for vaccinations. Pregnant women are recommended to wait until after they deliver to receive the vaccination. [7] Anyone with allergy concerns especially to yeast should consult their physician. [7]

Initially, Gardasil (bivalent, quadrivalent, and 9-valent versions) and Cervarix brands were available; [7] however, as of now only Gardasil 9 (9-valent) is available for vaccination in the U.S. [7] (9-valent simply refers to the 9 strains that the vaccine helps to protect against that are known to be associated with cancers).

The World Health Organization (WHO) says between 30% and 50% of cancer deaths could be prevented by avoiding alcohol and tobacco products, especially concurrent use. It also indicates there are about 529,000 new cases of cancers of the oral cavity and pharynx each year, and more than 300,000 deaths. [8] "The American Cancer Society's most recent estimates for oral cavity and oropharyngeal cancers in the United States for 2017 are that about 49,670 people will get oral cavity or oropharyngeal cancer and an estimated 9,700 people will die of them." [3]

Related Research Articles

<span class="mw-page-title-main">Wart</span> Small, rough growth resembling a cauliflower or a solid blister

Warts are non-cancerous viral growths usually occurring on the hands and feet but can also affect other locations, such as the genitals or face. One or many warts may appear. They are distinguished from cancerous tumors as they are caused by a viral infection, such as a human papillomavirus, rather than a cancerous growth.

<span class="mw-page-title-main">Cervical cancer</span> Cancer arising from the cervix

Cervical cancer is a cancer arising from the cervix or in the any layer of the wall of the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse. While bleeding after sex may not be serious, it may also indicate the presence of cervical cancer.

<span class="mw-page-title-main">Human papillomavirus infection</span> Human disease

Human papillomavirus infection is caused by a DNA virus from the Papillomaviridae family. Many HPV infections cause no symptoms and 90% resolve spontaneously within two years. In some cases, an HPV infection persists and results in either warts or precancerous lesions. These lesions, depending on the site affected, increase the risk of cancer of the cervix, vulva, vagina, penis, anus, mouth, tonsils, or throat. Nearly all cervical cancer is due to HPV, and two strains – HPV16 and HPV18 – account for 70% of all cases. HPV16 is responsible for almost 90% of HPV-positive oropharyngeal cancers. Between 60% and 90% of the other cancers listed above are also linked to HPV. HPV6 and HPV11 are common causes of genital warts and laryngeal papillomatosis.

<span class="mw-page-title-main">Genital wart</span> Sexually transmitted infection caused by certain types of human papillomaviruses

Genital warts are a sexually transmitted infection caused by certain types of human papillomavirus (HPV). They may be flat or project out from the surface of the skin, and their color may vary; brownish, white, pale yellow, pinkish-red, or gray. There may be a few individual warts or several, either in a cluster or merged together to look cauliflower-shaped. They can be itchy and feel burning. Usually they cause few symptoms, but can occasionally be painful. Typically they appear one to eight months following exposure. Warts are the most easily recognized symptom of genital HPV infection.

<span class="mw-page-title-main">Anal cancer</span> Medical condition

Anal cancer is a cancer which arises from the anus, the distal opening of the gastrointestinal tract. Symptoms may include bleeding from the anus or a lump near the anus. Other symptoms may include pain, itchiness, or discharge from the anus. A change in bowel movements may also occur.

<span class="mw-page-title-main">Head and neck cancer</span> Cancer arises in the head or neck region

Head and neck cancer develops from tissues in the lip and oral cavity (mouth), larynx (throat), salivary glands, nose, sinuses, or skin of the face. The most common types of head and neck cancer occur in the lips, mouth, and larynx. Symptoms predominantly include a sore that does not heal or a change in the voice. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity. Given the location of these cancers, it is possible for an afflicted individual to experience difficulty breathing.

<span class="mw-page-title-main">Papilloma</span> Medical condition

A papilloma is a benign epithelial tumor growing exophytically in nipple-like and often finger-like fronds. In this context, papilla refers to the projection created by the tumor, not a tumor on an already existing papilla.

<span class="mw-page-title-main">Cervical intraepithelial neoplasia</span> Medical condition

Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer. More specifically, CIN refers to the potentially precancerous transformation of cells of the cervix.

<span class="mw-page-title-main">HPV vaccine</span> Class of vaccines against human papillomavirus

Human papillomavirus (HPV) vaccines are vaccines that prevent infection by certain types of human papillomavirus (HPV). Available HPV vaccines protect against either two, four, or nine types of HPV. All HPV vaccines protect against at least HPV types 16 and 18, which cause the greatest risk of cervical cancer. It is estimated that HPV vaccines may prevent 70% of cervical cancer, 80% of anal cancer, 60% of vaginal cancer, 40% of vulvar cancer, and show more than 90% efficacy in preventing HPV-positive oropharyngeal cancers. They additionally prevent some genital warts, with the quadrivalent and nonavalent vaccines that protect against HPV types HPV-6 and HPV-11 providing greater protection.

<span class="mw-page-title-main">Childhood immunizations in the United States</span>

The schedule for childhood immunizations in the United States is published by the Centers for Disease Control and Prevention (CDC). The vaccination schedule is broken down by age: birth to six years of age, seven to eighteen, and adults nineteen and older. Childhood immunizations are key in preventing diseases with epidemic potential.

<span class="mw-page-title-main">Gardasil</span> Human papillomavirus vaccine

Gardasil is an HPV vaccine for use in the prevention of certain strains of human papillomavirus (HPV). It was developed by Merck & Co. High-risk human papilloma virus (hr-HPV) genital infection is the most common sexually transmitted infection among women. The HPV strains that Gardasil protects against are sexually transmitted, specifically HPV types 6, 11, 16 and 18. HPV types 16 and 18 cause an estimated 70% of cervical cancers, and are responsible for most HPV-induced anal, vulvar, vaginal, and penile cancer cases. HPV types 6 and 11 cause an estimated 90% of genital warts cases. HPV type 16 is responsible for almost 90% of HPV-positive oropharyngeal cancers, and the prevalence is higher in males than females. Though Gardasil does not treat existing infection, vaccination is still recommended for HPV-positive individuals, as it may protect against one or more different strains of the disease.

<span class="mw-page-title-main">Bovine papillomavirus</span> Group of viruses

Bovine papillomaviruses (BPV) are a paraphyletic group of DNA viruses of the subfamily Firstpapillomavirinae of Papillomaviridae that are common in cattle. All BPVs have a circular double-stranded DNA genome. Infection causes warts of the skin and alimentary tract, and more rarely cancers of the alimentary tract and urinary bladder. They are also thought to cause the skin tumour equine sarcoid in horses and donkeys.

Cervarix is a vaccine against certain types of cancer-causing human papillomavirus (HPV).

Margaret Anne Stanley, OBE FMedSc, is a British virologist and epithelial biologist. She attended the Universities of London, Bristol, and Adelaide. As of 2018, she is an Emeritus Professor of Epithelial Biology in the Department of Pathology at the University of Cambridge and a Fellow of the Academy of Medical Sciences. She is also an Honorary Fellow of the UK Royal College of Obstetricians and Gynaecologists and an honorary fellow of Christ's College, Cambridge. Stanley is a research scientist in virology focusing on the human papillomavirus (HPV). Her research work has led to new scientific findings on HPV. Additionally, she uses her expertise on HPV to serve on multiple advisory committees and journal editorial boards.

<span class="mw-page-title-main">Condom effectiveness</span>

Condom effectiveness is how effective condoms are at preventing STDs and pregnancy. Correctly using male condoms and other barriers like female condoms and dental dams, every time, can reduce the risk of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) and viral hepatitis. They can also provide protection against other diseases that may be transmitted through sex like Zika and Ebola. Using male or female condoms correctly, every time, can also help prevent pregnancy.

HspE7 is an investigational therapeutic vaccine candidate being developed by Nventa Biopharmaceuticals for the treatment of precancerous and cancerous lesions caused by the human papillomavirus (HPV). HspE7 uses recombinant DNA technology to covalently fuse a heat shock protein (Hsp) to a target antigen, thereby stimulating cellular immune system responses to specific diseases. HspE7 is a patented construct consisting of the HPV Type 16 E7 protein and heat shock protein 65 (Hsp65) and is currently the only candidate using Hsp technology to target the over 20 million Americans already infected with HPV.

<span class="mw-page-title-main">Sexually transmitted infection</span> Infection transmitted through human sexual behavior

A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, or sometimes manual sex. STIs often do not initially cause symptoms, which results in a risk of passing the infection on to others. Symptoms and signs of STIs may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. Some STIs can cause infertility.

<span class="mw-page-title-main">Oropharyngeal cancer</span> Pharynx cancer that is located in the oropharynx

Oropharyngeal cancer, also known as oropharyngeal squamous cell carcinoma and tonsil cancer, is a disease in which abnormal cells with the potential to both grow locally and spread to other parts of the body are found in the oral cavity, in the tissue of the part of the throat (oropharynx) that includes the base of the tongue, the tonsils, the soft palate, and the walls of the pharynx.

<span class="mw-page-title-main">HPV-positive oropharyngeal cancer</span> Cancer of the throat

Human papillomavirus-positive oropharyngeal cancer, is a cancer of the throat caused by the human papillomavirus type 16 virus (HPV16). In the past, cancer of the oropharynx (throat) was associated with the use of alcohol or tobacco or both, but the majority of cases are now associated with the HPV virus, acquired by having oral contact with the genitals of a person who has a genital HPV infection. Risk factors include having a large number of sexual partners, a history of oral-genital sex or anal–oral sex, having a female partner with a history of either an abnormal Pap smear or cervical dysplasia, having chronic periodontitis, and, among men, younger age at first intercourse and a history of genital warts. HPV-positive OPC is considered a separate disease from HPV-negative oropharyngeal cancer.

The Oral Cancer Foundation, sometimes abbreviated to OCF, is an American, IRS-registered, 501(c)(3) non-profit organization, which focuses on oral and oropharyngeal cancer related issues and public awareness of the disease.

References

  1. 1 2 3 Crooks, R.; Baur, K. (2014). Our Sexuality. Belmont, CA: Wadsworth Cengage. ISBN   9781133943365.
  2. 1 2 3 "STD Facts - Human papillomavirus (HPV)". www.cdc.gov. Retrieved 2017-04-01.
  3. 1 2 3 "What Are the Key Statistics About Oral Cavity and Oropharyngeal Cancers?". www.cancer.org. Retrieved 2017-02-18.
  4. ↑ "Final Recommendation Statement: Oral Cancer: Screening - US Preventive Services Task Force". www.uspreventiveservicestaskforce.org. Retrieved 2017-02-18.
  5. ↑ "Oral and Oropharyngeal Cancer". www.ada.org. Retrieved 2017-02-18.
  6. 1 2 Viens, Laura J.; Henley, S. Jane; Watson, Meg; Markowitz, Lauri E.; Thomas, Cheryll C.; Thompson, Trevor D.; Razzaghi, Hilda; Saraiya, Mona (2016-01-01). "Human Papillomavirus–Associated Cancers — United States, 2008–2012". MMWR. Morbidity and Mortality Weekly Report. 65 (26): 661–666. doi: 10.15585/mmwr.mm6526a1 . ISSN   0149-2195. PMID   27387669.
  7. 1 2 3 4 5 "Vaccine Information Statement | HPV | VIS | CDC". www.cdc.gov. Retrieved 2017-04-22.
  8. ↑ "WHO Cancer Control Programme". World Health Organization. Retrieved 2017-02-18.
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