Source: professional.cancerconsultants.com
Author: staff

Researchers from the University of Michigan have reported that current tobacco users with advanced, human papillomavirus (HPV)-positive oropharyngeal cancer are at increased risk of disease recurrence. The details of this study were published in the February 15, 2010 issue of Clinical Cancer Research.[1]

Human papillomaviruses are probably the sole cause of cancers of the cervix and have been associated with cancers of the vulva, vagina, penis, and rectum. Epidemiologic and molecular biology studies have also suggested that HPV infection may be associated with cancers of the head and neck. The overall frequency of HPV in benign and precancerous lesions ranges from 18.5% to 35.9%, depending upon the detection methodology. Researchers affiliated with an international study have also that reported that oral infection with HPV is associated with the development of head and neck cancers. These authors concluded that HPV infection increased the risk of oropharyngeal cancer in both users and non-users of alcohol and tobacco.

These authors also suggested that the more prevalent practice of oral sex may explain the increased incidence of tonsillar and base-of-the-tongue cancers since 1973. Researchers from the University of Maryland and Harvard University have also reported that the better survival among White patients compared with African-American patients with oropharyngeal cancer appears to be due, at least in part, to the higher prevalence of human papillomavirus (HPV)-related cancers in White patients.

The current study evaluated the effect of tobacco usage on the outcomes of patients with HPV-related advanced oropharyngeal cancer. These authors made the following observations:

  • 86% of 124 patients with advanced oropharyngel squamous cell cancer diagnosed between 1999 and 2007 were positive for HPV.
  • 68% of HPV-positive patients were tobacco users.
  • Current tobacco users had a fivefold increased risk of disease recurrence.
  • 35% of HPV-positive patients who used tobacco had recurrences compared with 6% for never users and 50% for HPV-negative patients.
  • All HPV-negative patients were tobacco users and had rapid disease recurrence and poor overall survivals compared with HPV-positive patients.

Comment:
These data suggest that patients with HPV-positive oropharyngeal cancer have a better outcome than patients with HPV-negative tobacco-related disease. However, outcomes in HPV-positive patients are compromised by current tobacco use.

Reference:
[1] Maxwell JH, Kumar B, Feng FY, et al. Tobacco use in human papillomavirus-positive advance oropharynx cancer patients related to increased risk of distant metastases and tumor recurrence. Clinical Cancer Research. 201016:1226-1235.