March 8, 2009

Distinction Made Between Head and Neck Cancers Resulting from Different Risk Factors


Distinction Made Between Head and Neck Cancers Resulting from Different Risk Factors

Recent research indicates that head and neck cancers associated with a certain form of human papillomavirus (HPV) and those not associated with HPV may be linked with different risk factors. Identifying these differing risk factors may further distinguish the two forms of head and neck cancer from each other. These findings were published in the Journal of the National Cancer Institute.

Some forms of head and neck cancer are associated with HPV-16, a serious subtype of HPV. Other forms of head and neck cancer, however, have no association with HPV-16 and may result from risk factors such as alcohol and tobacco use and poor oral hygiene.

Human papilloma virus (HPV) is one of the most common viruses in the world and often affects the skin and mucosal areas of the body. More than 80 different types of HPV have been identified. Infection with virus occurs when an area where the virus is present comes in contact with other skin cells. Common sources of transmission include sexual activity.

In this recent study, researchers compared risk factors for patients with head and neck cancer who were positive for HPV-16 with those who were negative for HPV-16. Researchers evaluated 240 patients diagnosed with head and neck cancers at the Johns Hopkins Hospital between 2000 and 2006. Each patient was evaluated for the presence of HPV-16 and then matched with two control subjects who did not have cancer. For patients who tested positive for HPV-16, information was collected on risk and lifestyle factors that may have contributed to acquiring the virus. For patients who tested negative for HPV-16, risk and lifestyle factors were evaluated that may be associated with the development of head and neck cancer.

Findings for HPV-16 positive head and neck cancer:

  • HPV-16 was identified in 92 of the 240 cases of head and neck cancer.
  • HPV-16 was detected among head and neck cancer patients who had previously been exposed to marijuana and certain sexual behaviors.
  • Tobacco exposure, poor oral hygiene, and alcohol consumption were not associated with HPV-16.
  • The strength of the association between HPV-16 and head and neck cancers was increased with an increased number of oral sexual partners and increased marijuana use.

Findings for HPV-16 negative head and neck cancer:

  • Head and neck cancers that were not associated with HPV-16 were strongly associated with increased exposure to tobacco, alcohol, and poor oral hygiene but not with sexual behavior or marijuana use.
  • Overall, comparisons among subjects who had neither smoked tobacco nor drank alcohol revealed that heavy use of either substance increased their risk of head and neck cancers not due to HPV-16.

Researchers concluded that the different risk profiles for head and neck cancers indicate that HPV-16 head and neck cancers and non–HPV-16 head and neck cancers should be considered as distinct diseases. Approaches to treatment and management of these cancers may reflect this distinction.

Reference: Gillison, M., Gypsymaber, D., Westra, W. et al. Distinct risk factor profiles for human papillomavirus type 16-negative head and neck cancers. Journal of the National Cancer Institute. 2008 100(6): 407-420.

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