The most common sexually transmitted infection (STI) is genital human papillomavirus (HPV). HPV can infect the genital areas of both men and women and can also infect the mouth and throat. There are more than 40 types of HPV. Most people who become infected with HPV will not even know that they are infected.
HPV causes a distinct form of oropharyngeal (throat) squamous cell carcinoma cancer (OPSCC) that is associated with sexual behavior. In the United States, the incidence of OPSCC increased from 1973 to 2004, especially among younger people, men, and white individuals. Survival rates also increased between 1973 and 2004. Since survival rates are better for HPV-positive patients with OPSCC than for HPV-negative patients with OPSCC, for whom their cancers are often associated with alcohol and tobacco use, it was suggested that more cases of OPSCC were being caused by HPV over time.
In an analysis of tumors from 271 of 5,755 patients from Hawaii, Iowa, and Los Angeles, California with OPSCCs from 1984 to 2004, a recently reported study found an increased prevalence of HPV in the tumors over time and also found that the long-term survival (defined as over 15 years after the diagnosis of cancer) of HPV-positive patients was signficantly better than for HPV-negative patients (62 deaths compared to 135 deaths and mean survival of 131 months compared to 20 months) – the median survival for HPV-positive patients increased over time while the median survival of HPV-negative patients remained unchanged over time.
After adjustments for age of the patients, stage of the cancer, year of diagnosis, and treatment received (or not received) by the patient, the study found that HPV-positive patients had a 69% reduction in risk of death when compared to HPV-negative patients. The difference in survival between the HPV-positive and the HPV-negative patients was greater for patients treated by radiation than for those who were not treated by radiation.
From 1988 to 2004, the incidence of HPV-positive OPSCCs increased by 225% but the incidence of HPV-negative OPSCCs decreased by by 50% – the overall incidence of OPSCCs increased by 28% from 1988 to 2004. The prevalence of HPV in oropharyngeal tumors increased from 16.3% during the 1980s to 72.7% during the 2000s.
The study estimated that by 2010, the incidence of OPSCCs in men surpassed the incidence of cervical cancers. The study estimated that by 2020, the annual number of HPV-positive OPSCCs (about 8,700 patients) will surpass the annual number of cervical cancers (about 7,700 patients) and that a majority will be for men (about 7,400 male patients). By 2030, it is estimated that OPSCCs will represent 47% of all head and neck cancers in the United States.
The study concluded that about 70% of OPSCCs are now caused by HPV.
In light of the findings of the study, the efficacy of HPV vaccination of females and the potential for HPV vaccination of males are important considerations for people who may otherwise be diagnosed with OPSCCs in the future.
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