human papillomavirus – Page 24

Can saliva-based HPV tests establish cancer risk and guide patient management?

Source: Oral and Maxillofacial Pathology doi:10.1016 Author: Mark W. Lingen, DDS, PhD Section Editor, Oral and Maxillofacial Pathology Head and neck squamous cell carcinoma (HNSCC) is the 6th most common malignancy in the world today.1 Despite numerous advances in treatment, the 5-year survival rate has remained modest. This poor outcome is due to several factors, including delayed diagnosis. Therefore, improved early detection and effective prevention strategies are critical components for management of this malignancy. The etiology of classical HNSCC has been attributed to chronic exposure to tobacco and alcohol.2 In addition, there is now sufficient evidence to support the contention that high-risk forms of the human papillomavirus (HPV) are a major causative factor for HNSCC of the tonsil, base of tongue, and oropharynx.3-8 The increasing importance of HPV in oropharyngeal HNSCC has raised considerable concern and uncertainty among healthcare professionals and patients. For example, I am often asked to describe the clinical features of HPV-associated premalignant lesions. Unfortunately, to my knowledge, the clinical spectrum of HPV-associated premalignant disease has not been adequately described. Furthermore, because this subset of HNSCC often develops in hard to- examine locations, such as tonsillar crypts, it can be exceedingly difficult to even identify the carcinomas. In the absence of such information, how can clinicians identify patients that are at increased risk for harboring an HPV-associated premalignant lesions or HNSCC? Recently, a large commercial diagnostic lab began offering a saliva-based test for the identification of oral HPV infections. As a result of this new offering, I [...]

Oral Cancer Foundation News Team - A2010-08-31T12:09:37-07:00August, 2010|Oral Cancer News|

Dermatologist discusses advantages of vaccines that prevent human papillomavirus and herpes zoster

Source: www.prnewswire.com Author: public release Vaccines have a long history of successfully preventing disease and, in effect, improving the lives of countless Americans. Now, two serious diseases – human papillomavirus (HPV) and herpes zoster – could become a thing of the past as people better understand the safety and efficacy of vaccines to prevent these serious viral infections in specific populations. At the American Academy of Dermatology's Summer Academy Meeting 2010 in Chicago, dermatologist Jeffrey M. Weinberg, MD, FAAD, associate clinical professor of dermatology at Columbia University College of Physicians and Surgeons in New York City, highlighted the significant benefits associated with these two new vaccines. HPV Vaccine Protects Girls and Boys HPV is a group of viruses commonly linked to the sexually transmitted diseases known as genital HPV infection, which have long been associated with the development of cervical cancer, a life-threatening cancer. According to the American Cancer Society's 2010 estimates, approximately 4,210 women will die from cervical cancer in the United States. In 2006, a breakthrough vaccine was approved by the FDA for the prevention of HPV types 6, 11, 16 and 18. HPV types 6 and 11 are responsible for more than 90 percent of all cases of genital warts, and HPV types 16 and 18 cause 70 percent of all cervical cancers. Although the vaccine is specifically approved for use in females 9 to 26 years of age, Dr. Weinberg acknowledged that many people are still reluctant to get the vaccination due to a lack of [...]

Oral Cancer Foundation News Team - A2010-08-29T08:09:12-07:00August, 2010|Oral Cancer News|

Should boys also get vaccinated for HPV?

Source: www.npr.org Author: Brenda Wilson Many adolescents are having back-to-school visits with their doctors. That usually means shots — including, for some, the HPV vaccine. It's mainly given to adolescent girls to protect against the human papillomavirus, which causes cervical cancer. But there's a debate among scientists about whether to immunize boys as well. 'Herd Immunity' If this were a high school debate, it would go something like this: Be it resolved that all adolescent girls and boys should be vaccinated against HPV before they are sexually active, since more than half of all sexually active men and women will get HPV at some point in their lives. In the affirmative, there's Dr. Doug Lowy, co-inventor of the HPV vaccine who works at the National Cancer Institute. He says that since just 11 percent of girls now get all three doses of the vaccine and less than half get even one dose, rates of HPV in the U.S. are unlikely to come down very much. So, he says, let's offer the vaccine to boys as well. "When the percentage of girls getting vaccinated are in the 30 to 40 percent range, vaccinating boys is suggested to have a substantial enhancing impact on trying to protect those girls who are not vaccinated," Lowy says. He says it would provide "herd immunity." Boys don't get cervical cancer, but they can transmit HPV. So vaccinating boys would reduce the amount of HPV circulating in the population. Practical Dilemmas Speaking for the opposing side, [...]

Oral Cancer Foundation News Team - A2010-08-22T12:21:20-07:00August, 2010|Oral Cancer News|

HPV-positive oropharnygeal cancer has better prognosis than tobacco-induced cancer

Source: www.enttoday.org Author: Alice Goodma Mounting evidence suggests that human papillomavirus (HPV)-positive oropharyngeal cancer has an improved prognosis compared with HPV-negative disease. The most recent supportive evidence comes from an analysis of a Phase III trial presented at the 2009 annual meeting of the American Society of Clinical Oncology. Our study showed that HPV status is as strong a predictor of outcome as cancer stage for patients with oropharyngeal cancers, even after considering other factors such as age and smoking history, said lead author Maura Gillison, MD, PhD, Professor of Hematology and Oncology, Epidemiology, and Otolaryngology at Ohio State University in Columbus. Dr. Gillison said that tumor HPV status should now be part of the routine workup of patients with oropharyngeal cancers. Oropharyngeal cancers are mainly attributable to chronic tobacco use and smoking, or to HPV infection. Retrospective analyses, meta-analysis, and small trials have suggested that HPV-positive oropharyngeal cancer is a distinct entity, and the present Phase III study provides the most compelling evidence, she said, because it is the largest study to date. It is not clear why HPV-associated oropharyngeal cancer has a better prognosis. In the trial, HPV-positive patients were younger, mostly Caucasian, and had improved performance status and smaller tumors. Dr. Gillison said that these factors could have a positive influence on survival. Survival Benefit The retrospective correlative analysis of Radiation Therapy Oncology Group (RTOG) 0129, presented by Dr. Gillison, focused on outcome according to HPV status. The randomized study included 206 patients with cancers positive for [...]

Oral Cancer Foundation News Team - A2010-08-16T10:19:03-07:00August, 2010|Oral Cancer News|

High-risk human papillomavirus in esophageal squamous cell carcinoma

Source: cebp.aacrjournals.org Authors: Annika Antonsson et al Background: Although most cases of esophageal squamous cell carcinoma (ESCC) in western populations have been attributed to high levels of exposure to tobacco and alcohol, infectious agents have been postulated as possible causes, particularly human papillomavirus (HPV). Methods: To explore this issue, we analyzed HPV DNA prevalence and HPV types together with lifestyle factors, in relation to tumor stage and survival in a low-incidence population. Archived tumor samples from a nationwide cohort of 222 ESCC patients were tested for the presence of HPV DNA by PCR; positive samples were sequenced to determine HPV type, and p16INK4a status was assessed by immunohistochemistry. Results: Of 222 ESCC patients, 8 tested HPV positive (prevalence, 3.6%; 95% confidence interval, 1.1-6.1%), of which 6 were HPV-16 positive and 2 were HPV-35 positive. Four of the eight HPV-positive tumors overexpressed p16INK4a. None of 55 normal esophageal tissue samples from healthy participants had any detectable HPV. Although the numbers were low, it seemed that patients with HPV-positive ESCC tumors were younger than those with HPV-negative tumors (mean age, 60.8 versus 65.3 years, P = 0.18) and had higher body mass index (BMI) throughout life (mean current BMI of 25.1 for HPV positive, 22.2 for HPV negative, P = 0.08; mean BMI at 20 years of 25.8 for HPV positive, 22.1 for HPV negative, P = 0.003). We found no difference between patients with HPV-positive and HPV-negative tumors with respect to other lifestyle factors. Conclusions: These findings suggest a very low [...]

Oral Cancer Foundation News Team - A2010-08-11T16:20:50-07:00August, 2010|Oral Cancer News|

Fluorescent probe for oral cancer

Source: www.physorg.com Author: staff/ UC Davis Approximately 43,000 people in the U.S. are diagnosed with tumors of the mouth, pharynx and larynx each year. The main risk factor is smoking, but a recent rise in cases has been linked to human papillomavirus. Most cases are not diagnosed until the cancer has reached an advanced stage. "There's a lot out there about breast, prostate and brain cancer, but people are not so aware about oral cancer and its devastating consequences," said Laura Marcu, a professor of biomedical engineering at UC Davis. "People don't think to look for it, and there isn't any routine screening." Marcu's laboratory collaborated with Dr. Gregory Farwell's group in the Department of Otolaryngology at the UC Davis Cancer Center to develop the fiber-optic probe. The probe stimulates molecules in the patient's tissues with a laser. Some of these molecules naturally respond by re-emitting fluorescent light. The device rapidly detects and analyzes this light using a process called "time-resolved fluorescence spectroscopy" (TR-LIFS), which provides information about the types of molecules present. During surgery, blood can distort the intensity of the fluorescence signal but not its duration. By using sensitive measurements of the change in fluorescence over time, surgeons can see the tumor margins even as they are cutting the tissue. Based on encouraging results in animal tests, Marcu and Farwell's team recruited nine human volunteers from among patients who arrived at the UC Davis Medical Center for surgical therapy of the mouth, throat and larynx. They compared readings [...]

Oral Cancer Foundation News Team - A2010-08-04T12:55:16-07:00August, 2010|Oral Cancer News|

Vaccines might help fight throat cancer, but hurdles are high

Source: www.npr.org Author: Chao Deng There's been a big and controversial push to protect girls from cervical cancer by vaccinating them against the human papillomavirus. Turns out, the same vaccine might also protect boys from developing throat cancer later in life. Researchers estimate HPV causes more than 11,000 cases of throat cancers in the U.S. each year. Many are cropping up in younger people, especially in white men. Changes in sexual behavior have led to an increase in that could mean more than 20,000 cases annually by 2015, Forbes reports. So wouldn't you think that a growing market like that would be attractive to makers of HPV vaccines? Not so much, it turns out. Merck's Gardasil vaccine is approved for use in boys, but only to protect against genital warts. And a company spokeswoman told us in an email that Merck isn't looking to pursue approval of a throat-cancer indication anytime soon because of "competing research and business priorities." Same goes for Glaxo, according to Forbes. A big hurdle is that doctors can't screen for throat cancer the way they can for cervical cancer with a Pap smear. Without a simple test, it's harder to show the HPV vaccine reduces the risk of throat cancer. And that, in turn, makes it harder for vaccine makers to run a study that will pass muster with the Food and Drug Administration. But the outlook isn't completely bleak. Ohio State researcher Maura Gillison, who got funding for a pilot vaccine study [...]

Oral Cancer Foundation News Team - A2010-07-25T20:21:36-07:00July, 2010|Oral Cancer News|

HPV testing following excisional therapy for cervical neoplasia can identify high-risk patients: presented at IPC

Source: www.docguide.com Author: Louise Gagnon About one-quarter of women continue to have high-risk human papillomavirus (HPV) after excisional therapy for cervical intraepithelial neoplasia (CIN) 2/3, a study presented here at the 26th International Papillomavirus Conference (IPC) has found. Women with CIN are at increased risk for developing invasive cervical cancer, and persistent infection of high-risk HPV is a main risk factor for treatment failure, said Wendy Mei, BSc, MLT, the study's presenting investigator and clinical trials coordinator at the British Columbia Centre for Disease Control, Vancouver, British Columbia. HPV testing and Pap smear together are more sensitive than using Pap smear alone, noted Mei. "We wanted to evaluate the impact of implementing ASCCP [American Society for Colposcopy and Clinical Pathology] guidelines in British Columbia," Mei told attendees here at an oral presentation on July 7. "We also wanted to determine the genotype distribution of women with higher risk HPV to gain insight on vaccine and diagnostics evaluation." Researchers used ThinPrep to collect cervical brushings, instead of conventional Pap smear, to permit an aliquot to be tested to determine if the HPV types were high-risk using a DNA test. Mei and colleagues collected 1,007 specimens and found 25.4% (n = 256) were positive for high-risk HPV. They found HPV 16 in 29.7% of specimens and HPV 18 in 5.5% of specimens. "HPV 18 was lower than expected, but the treatment options are more effective for HPV 18," said Mei in an interview. Investigators found single and multiple high-risk HPV genotypes were [...]

Oral Cancer Foundation News Team - A2010-07-16T14:06:44-07:00July, 2010|Oral Cancer News|

Sharp rise in HPV-related oropharyngeal carcinoma — a legacy of the “sexual revolution”?

Source: MedScape Author: Zosia Chustecka March 30, 2010 — The incidence of oropharyngeal carcinoma related to human papillomavirus (HPV) has been increasing in recent years, and there is speculation that this is the result of the "sexual revolution" of the 1960s. This increase in the incidence of HPV-related oropharyngeal cancer has important public health implications, British experts warn in an editorial published online March 25 in the British Medical Journal. HPV-related oropharyngeal carcinoma appears to be a new and distinct disease entity, with better survival than the classic non-HPV-related disease, they point out. "These patients are typically younger and employed, and — because outcomes seem to be more favorable than for patients with non-HPV-related carcinoma — they will live longer with the functional and psychological sequelae of their treatment. Consequently, they need prolonged support from health, social, and other services, and may require help returning to work," write the authors, headed by Hisham Mehanna, BMedSc, MB ChB, FRCS, director of the Institute of Head and Neck Studies and Education at University Hospital in Coventry, United Kingdom. However, currently, there is no good evidence to support managing patients with HPV-related head and neck cancer differently from those whose tumors are not HPV-related, the researchers write. Several studies are being planned to evaluate different treatment options, and Dr. Mehanna and colleagues urge clinicians to offer all patients with oropharyngeal cancer the opportunity to enroll in a clinical trial. However, until data from those trials are available, "we suggest that clinicians should not change their current [...]

Charlotte Parker2010-06-18T08:06:16-07:00June, 2010|Oral Cancer News|

ASCO: Second study links HPV to mouth cancer outcomes

Source: www.medpagetoday.com/ Author: Michael Smith, North American Correspondent, MedPage Today Human papillomavirus (HPV) infection predicts a better chance of survival in patients with oropharyngeal squamous cell carcinoma, researchers said. In a retrospective analysis of a major radiation therapy trial, more than four-fifths of patients whose tumors were HPV-positive were alive three years after treatment, according to Maura Gillison, MD, PhD, of Ohio State University in Columbus, and colleagues. In contrast, fewer than six of 10 patients with HPV-negative tumors were still alive at the three-year mark, Gillison and colleagues reported online in the New England Journal of Medicine, in an article released to coincide with a presentation at the American Society of Clinical Oncology meeting here. The study follows a report earlier at the meeting that found a similar pattern among patients enrolled in a chemotherapy trial. The virus is, of course, well known to cause cervical cancer. The New England Journal study adds to the evidence that "HPV-positive oropharyngeal squamous-cell carcinoma represents a distinct clinicopathological entity associated with a better prognosis than HPV-negative oropharyngeal squamous-cell carcinoma," said Douglas Lowy, MD, of the NIH, and Karl Munger, PhD, of Brigham and Women's Hospital in Boston. Writing in an accompanying editorial, Lowy and Munger argued that if the diseases are distinct, "their treatment or prevention might benefit from different approaches." One possibility, they said, would be to target HPV proteins to treat the disease in some patients, while prevention might involve vaccination against the virus. Gillison and colleagues looked at the [...]

Oral Cancer Foundation News Team - A2010-06-07T16:09:05-07:00June, 2010|OCF In The News, Oral Cancer News|