HPV related oral squamous cell carcinoma – What’s the link?

April is oral cancer awareness month!  This post, however, is much more specific.  We will discuss the link between HPV and oropharyngeal cancer.  The human papillomavirus virus (HPV) has over 100 varieties and about 40 we consider sexually-transmitted.  HPV is resulting in the fastest growing segment of oral cancer patients, those being young, healthy, nonsmoking individuals.   HPV accounts for a 225% increase in cancer from 1988 to 2004 Chatraverdi 2011.  The rates of oropharyngeal cancer continue to increase.  HPV is strongly linked to posterior orophayngeal, tonsil cancer, which have the worst survival rates of all oral cancers, and the base of the tongue.  Currently HPV is not strongly linked to the other oral cancers, although you will erroneously see this reported often.

• HPV is highly associated to oropharynx SSC, especially tonsil
• 70-75% oropharyngeal SSC is HPV+ and 60% of these are HPV-16 Goldstein 2019 Comp
• 90% HNC w/ HPV are subtype 16 (which also causes 75% of all cervical cancer) Dayyani 2010
• Survival rate of HPV cancer is higher than non HPV
• HPV+ tonsil SSC dramatically increasing
• HPV vaccine is very safe with zero reports of serious side effects to date (Goldtein above)

Treatment of oral HPV lesions

Surgical removal is one option and on adults is often the easiest. For children you can use TCA every 15 days until the lesion is gone. Place for 30-60 seconds and repeat every 2 weeks as needed. Lorduy 2018 General Dentistry

Research on HPV related oral squamous cell carcinoma

This article reviews the rapidly growing evidence that oral human papilloma viruses (HPV) infection contributes to the risk of oral squamous cell carcinoma. Sanders Oral Dis. 2012

Human papillomavirus (HPV) infection is the principal cause of a distinct form of oropharyngeal squamous cell carcinoma that is increasing in incidence among men in the United States. Gillison JAMA 2012

Human papillomavirus type 16 (HPV16) is a common infection in the anogenital tract. HPV16 DNA detected in oral specimens has recently been identified as a risk factor for some oropharyngeal cancers. Kreimer STD 2010

HPV DNA was detected in half of SCC penile cancer, with HPV16 being the most common type. If proven efficacious in men, prophylactic vaccines targeting carcinogenic types HPV16 and 18 could potentially reduce approximately one-third of incident SCC. Backes CCC 2009

Human papillomavirus (HPV) is a risk factor in a subset of oropharyngeal cancer; however, the contribution of HPV in the malignancy of oral squamous cell carcinomas (OSCC) is not fully understood in Taiwanese. Chuang PluS One 2012

International Agency for Research against Cancer (IARC) has acknowledged HPV, in addition to smoking and alcohol, as a risk factor for oropharyngeal squamous cell carcinoma OSCC Ramgvist Anticancer Res 2011

Although an association between head and neck SCC and HPV infection is being recognized and reported, our data implicate that HPV infection or TP53 expression does not play a significant role in oral tongue SCC pathogenesis, differentiation, or metastasis, as seen in our patients. Seraj PRP 2011

Our study confirms a positive correlation of HPV infection with oral tongue cancer. Elango 2011 J Cnacer Prev

Human papilloma viruses (HPV) may cause head and neck squamous cell carcinomas. HPV associated carcinomas mostly occur in the oropharynx and particularly in the palatine tonsil and base of tongue. Carcinomas at other sites are infrequently caused by HPV Reichelmann 2010 Deutsch