Oropharyngeal cancer epidemic and human papillomavirus

Source: Foodconsumer Author: Torbjörn Ramqvist and Tina Dalianis Abstract A growing body of research shows that human papillomavirus (HPV) is a common and increasing cause of oropharyngeal squamous cell carcinoma (OSCC). Thus, the International Agency for Research against Cancer has acknowledged HPV as a risk factor for OSCC, in addition to smoking and alcohol consumption. Recently, in Finland, the United Kingdom, the Netherlands, the United States, and Sweden, incidence of OSCC has increased, and an increase in the proportion of HPV-positive tumors was noted. On the basis of these data and reports indicating that patients with HPV-positive cancer have their first sexual experience at a young age and have multiple partners, we postulate that increased incidence of OSCC in the United States and some countries in northern Europe is because of a new, primarily sexually transmitted HPV epidemic. We also suggest that individualized treatment modalities and preventive vaccination should be further explored. In many countries, vaccines against some human papillomavirus (HPV) types are now administered to girls and young women with the goal of protecting them against HPV-induced cervical cancer (1,2). The introduction of HPV vaccines has also drawn more attention to the fact that HPV is associated not only with cervical cancer and genital warts but also with other tumors, such as head neck and anogenital cancers (3). We focus on the role of HPV in the increased incidence of oropharyngeal squamous cell carcinoma (OSCC), the head and neck cancer in which HPV is most commonly found (4). Head and neck cancer [...]

2010-11-09T20:51:27-07:00November, 2010|Oral Cancer News|

Does framing human papillomavirus vaccine as preventing cancer in men increase vaccine acceptability?

Source: PubMed.gov BACKGROUND: Human papillomavirus (HPV) vaccine is now approved for use in males in the United States to prevent genital warts. We conducted an experiment to see whether framing HPV vaccination as also preventing cancer in men would increase men's vaccination willingness. METHODS: We conducted an online survey in January 2009 with a national sample of men ages 18 to 59 years who self-identified as gay/bisexual (n = 312) or heterosexual (n = 296). In the within-subjects experiment, men read four randomly ordered vignettes that described hypothetical vaccines that prevented either genital warts alone, or genital warts and either anal cancer, oral cancer, or penile cancer. We analyzed data using repeated measures ANOVA and tested whether perceived severity or perceived likelihood mediated the effect of disease outcome framing on men's HPV vaccination willingness. RESULTS: Although only 42% of men were willing to receive HPV vaccine when it was framed as preventing genital warts alone, 60% were willing to get it when it was framed as preventing cancer in addition to genital warts (P < 0.001). The effect of outcome framing was the same for heterosexual and gay/bisexual men and for the three cancer types examined. Perceived severity of disease partially mediated the association between disease outcome and HPV vaccination willingness. CONCLUSIONS: Men may be more accepting of HPV vaccine when it is framed as preventing cancer, regardless which of the three most common HPV-related cancers in men is described. IMPACT: Study findings may be useful in developing health communication messages that maximize HPV vaccine [...]

2010-11-08T13:52:28-07:00November, 2010|Oral Cancer News|

Cancers attributable to human papillomavirus infection.

Source: PubMed.gov Although the human papillomavirus (HPV) vaccine was introduced primarily as a cervical cancer prevention vaccine, HPV has a causal role in several types of cancer. This article reviews the epidemiological evidence for the role of HPV in human cancer, and describes Australian trends in these cancers. HPV is a necessary cause of cervical cancer. The currently vaccine-preventable subtypes of HPV 16 and 18 are responsible for ~70% of cervical cancer. The introduction of an organised Pap smear program in Australia led to a steep decline in incidence over the past decades. HPV can be detected in ~40% and 70% of vulval and vaginal cancers respectively. Rates of these cancers have been stable over the past 20 years. The prevalence of HPV in penile cancer is ~50% and incidence has not recently changed. For anal cancer, ~85% of cases are HPV positive, and incidence has increased significantly in both men and women over the past 20 years. In the oral cavity, ~35% of oropharyngeal cancers and ~25% of other oral cavity cancers are HPV positive. The incidence of HPV-related oral cavity and oropharyngeal cancers is increasing, whereas incidence at HPV-unrelated sites is decreasing. Overall, 1154 HPV-related cancer cases were potentially preventable by vaccination. If HPV-related cancers at non-cervical sites are prevented by vaccination, then a similar number of cancer cases will be prevented as in the cervix. However, almost one-quarter of the potentially preventable cancer cases are in men, who are not included in the current national immunisation program.

2010-11-08T13:36:52-07:00November, 2010|Oral Cancer News|

Histopathologic findings of HPV and p16 positive HNSCC

Source: PubMed.gov OBJECTIVE: Human papilloma virus (HPV) and p16INKa (p16) positivity in head and neck squamous cell carcinomas (HNSCCs) is currently thought to be an encouraging prognostic indicator. However, the histopathologic changes responsible for this behavior are poorly understood. It is our objective to elucidate these histopathologic characteristics to help define the clinical utility of these markers. DESIGN: Retrospective cohort study. METHODS: 71 HNSCC tumors between July 1, 2008 and August 30, 2009 were examined for HPV, p16, and epidermal growth factor receptor (EGFR). Specified pathologic features were examined: perivascular invasion (PVI), perineural invasion (PNI), grade of squamous differentiation, basaloid classification. RESULTS: HPV and p16 had no direct impact on perineural or perivascular invasion. However, HPV and p16 were strongly predictive of poorly differentiated tumors, as well as basaloid squamous cell carcinoma (SCCA) (P < .001). Additionally, upon multivariate analysis, HPV(+) and p16(+) tumors had an increased risk of nodal metastasis (HPV: odds ratio [OR] = 23.9 (2.2, 265.1) p = .01; p16: OR = 6.5 (1.4, 31.2) p = .02; PVI: OR = 6.0 (1.6, 22.8) p < .01). The area under the curve (AUC) of receiver operating characteristic (ROC) curves demonstrated improved predictive value for lymph node metastasis above standard H&E histopathologic features (76.7%) for both HPV (83.2%) and p16 (81.3%) individually. CONCLUSIONS: HPV(+) and p16(+) are highly predictive for poorly differentiated tumors and basaloid SCCA. Additionally, HPV and p16 positivity demonstrate superior predictive value for lymph node metastasis above standard H&E histopathologic features. Although exact recommendations should be tempered by considerations of [...]

2010-11-08T13:31:34-07:00November, 2010|Oral Cancer News|

Would the effect of HPV vaccination on non-cervical HPV-positive cancers make the difference for its cost-effectiveness?

Source: PubMed.gov Besides cervical cancer, the human papillomavirus (HPV) is found in other cancers and may be preventable with HPV vaccination. However, these other cancers are often not accounted for in cost-effectiveness analyses of HPV vaccination. This study estimates the potential maximum effect on the cost-effectiveness ratio (CER) of HPV vaccination in preventing non-cervical HPV-positive cancers. For the Dutch situation, a mathematical equation was used to estimate the maximum impact if all cancer cases of the penis, vulva/vagina, anus, oral cavity and oro-pharynx with HPV16/18 are prevented, in terms of number of life years gained, savings and improvement in the CER of the vaccination. For other countries and for future developments, we show how the impact on the CER varies depending on the incidence of cervical/non-cervical HPV 16/18-positive cancers, vaccine costs and clinical costs. If in the Netherlands all HPV 16/18-positive cancers are prevented by vaccination in women only, compared to if only HPV 16/18-positive cervical cancer is prevented, the life years gained increase with 14%, the savings increase with 18%, and the CER decreases with 13%. If vaccination prevents HPV-positive cancers in both men and women, these figures increase to 25%, 26% and 21%, respectively. In conclusion, if HPV vaccination fully prevents all non-cervical HPV-positive cancers, this would substantially increase its cost-effectiveness. The impact of the vaccination varies depending on the incidence of cervical/non-cervical HPV16/18-positive cancers, the vaccine costs and clinical costs. Observed combinations of these parameters in different countries show a decrease in the CER between 10% and [...]

2010-11-08T13:20:40-07:00November, 2010|Oral Cancer News|

Superselective intra-arterial chemoradiotherapy with docetaxel-nedaplatin for advanced oral cancer.

Source: PubMed.gov Cisplatin-based, superselective, intra-arterial chemotherapy concurrent with radiotherapy (SSIACRT) has gained wide acceptance as a common/curative treatment for advanced head and neck cancer. We combined nedaplatin (CDGP) with docetaxel (DOC) as a new combination in SSIACRT for advanced oral squamous cell carcinoma in 2003. Twenty-two patients with advanced oral cancer were treated by radiotherapy (66Gy) concurrent with superselective intra-arterial DOC (40mg/body) and CDGP (80mg/m(2)) infusion between 2003 and 2009. Complete response was achieved in 18 (81.8%) of the 22 patients. Of the 17 patients with positive neck disease, 16 (94%) were assessed as disease-free. The 5-year overall survival rate was 78.5%, and the major adverse effects were leukocytopenia and mucositis. Five patients (22.7%) developed distant metastases post-treatment. These results indicate that intra-arterial docetaxel-nedaplatin infusion concurrent with radiotherapy is efficacious for advanced oral cancer. The side effects are easily manageable, and the most important outcome of the treatment is the preservation of patients' quality of life (QOL) and improved prognosis.

2010-11-08T13:13:31-07:00November, 2010|Oral Cancer News|

UC cancer drug trials offer lone hope

Source: news.cincinnati.com Author: Peggy O'Farrell Two years ago this month, Pam Cain learned the bump on her tongue was really cancer. Last year, she learned the "bump" had spread to both lungs. "Last November, I was given two years if I only did chemo," she said. So she underwent radiation therapy. But the lesions on her lungs stayed put, and the cancer spread to one hip. So far, three chemotherapy combinations failed to kill her cancer. Now Cain, 32, of Union is hoping an experimental targeted therapy will knock out her cancer. She was the second patient in the United States to receive the experimental drug, and one of about five patients now enrolled in four clinical trials for new cancer therapies at the University of Cincinnati. The phase 1 trials are part of UC's effort to raise its profile for cancer treatment and research. Phase 1 trials are the earliest stage of testing new medications or medical devices on humans. They're designed to determine if a new treatment is safe, not whether it works. For patients like Cain, who have run out of tried-and-true options, it means being able to get cutting-edge treatments close to home. "This way, I didn't have to leave my kids," she said. "I didn't have to travel. I didn't have to go someplace where I didn't know anybody. And financially, it would have hurt." For the researchers and physicians who conduct the trials, it's an opportunity to help find the next wonder drug. Olivier [...]

2010-11-07T09:41:21-07:00November, 2010|Oral Cancer News|

Oropharyngeal cancer epidemic and human papillomavirus

Source: www.foodconsumer.org Authors: Torbjörn Ramqvist and Tina Dalianis Abstract A growing body of research shows that human papillomavirus (HPV) is a common and increasing cause of oropharyngeal squamous cell carcinoma (OSCC). Thus, the International Agency for Research against Cancer has acknowledged HPV as a risk factor for OSCC, in addition to smoking and alcohol consumption. Recently, in Finland, the United Kingdom, the Netherlands, the United States, and Sweden, incidence of OSCC has increased, and an increase in the proportion of HPV-positive tumors was noted. On the basis of these data and reports indicating that patients with HPV-positive cancer have their first sexual experience at a young age and have multiple partners, we postulate that increased incidence of OSCC in the United States and some countries in northern Europe is because of a new, primarily sexually transmitted HPV epidemic. We also suggest that individualized treatment modalities and preventive vaccination should be further explored. Study In many countries, vaccines against some human papillomavirus (HPV) types are now administered to girls and young women with the goal of protecting them against HPV-induced cervical cancer (1,2). The introduction of HPV vaccines has also drawn more attention to the fact that HPV is associated not only with cervical cancer and genital warts but also with other tumors, such as head neck and anogenital cancers (3). We focus on the role of HPV in the increased incidence of oropharyngeal squamous cell carcinoma (OSCC), the head and neck cancer in which HPV is most commonly found (4). [...]

2010-11-07T09:39:03-07:00November, 2010|Oral Cancer News|

Diagnosis for Michael Douglas highlights oral cancer risk

Source: www.dental-tribune.com Author: Fred Michmershuizen, DTA After it became known recently that the Academy Award winning actor Michael Douglas has been diagnosed with oral cancer, dental professionals around the world seized on an opportunity to urge members of the public to pay more attention to key risk factors and early warning signs of the disease. The Academy Award winner was diagnosed with a tumor in his throat, and he now faces an eight-week course of chemotherapy and radiotherapy. This high-profile case has brought oral cancers into the limelight, and oral health experts are keen to make the public more aware of the key risk factors and early warning signs. The British Dental Health Foundation is calling for more attention to be paid to mouth cancers. The foundation is advising the public to regularly check their mouths. Douglas quit smoking in 2006, after a long “half a pack a day” habit. Yet, according to the foundation, the possibility of developing oral cancer remains higher for ex-smokers than non-smokers for 20 years after quitting. Tobacco is considered to be the main cause of mouth cancer, with three in four cases being linked to smoking, according to the foundation. Drinking in excess is also a known factor, with those who both smoke and drink to excess being up 30 times more likely to be at risk. “It is crucial the public know about the risk factors and early symptoms as early detection can save lives,” said Dr. Nigel Carter, chief executive of the [...]

2010-11-07T08:29:37-07:00November, 2010|Oral Cancer News|

Oral Cancer screening draws hundreds

Volunteer prosthodontists and oral surgeons, in conjunction with UCF’s Department of Communication Sciences and Disorders and Pre-Dental Society, conducted hundreds of free oral cancer screenings during a Nov. 3 outreach event held near the Student Union. “Our students and the doctors screened approximately 400 students, staff and faculty over six hours,” said Bari Hoffman-Ruddy, associate professor of communication sciences and disorders. “This is a record for us and the American College of Prosthodontist’s annual screening program.” The ACP is particularly interested in targeting a younger population for screenings because of the association between human papillomavirus (HPV) infection and oral cancer. According to the ACP, 25 percent of those newly diagnosed with oral cancer have no traditional risk factors, such as the use of tobacco or alcohol. “Much of the literature suggests a strong association between transmission of HPV via oral sex, and this is a relatively new demographic with oral cancer,” said Dr. John Whitsitt, a prosthodontist and ACP member from Daytona Beach who volunteered at the event. Students and faculty members worked at tables outside a large bus devoted to the screenings. They shared information about risk factors associate with oral cancer and encouraged people to have a free screening performed by a volunteer specialist. Each screening took just a few minutes. As of 1 p.m., no cases of oral cancer had been detected, said Whitsitt, who was clearly pleased with the turnout. ”But it’s just so important to increase awareness about it.”

2010-11-07T08:23:09-07:00November, 2010|Oral Cancer News|
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