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HPV-Related Oral Cancer Incidence Spikes Sharply

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‘Massive Increase’ Seen

The study demonstrates the massive increase taking place in the United States in HPV-related oropharyngeal cancer, and that this really will be the major form of head and neck cancer in the next decade.

The findings also support previous work from Sweden, although the two studies are not mirror images.

These are the kind of data that we need to inform the National Cancer Institute and the Centers for Disease Control and Prevention that more research support is needed to identify risks for this disease, to develop therapeutic vaccines, and to understand the immunity and carcinogenesis of this disease.

This disease really deserves research funding, because it is curable today with tools that are available and have not been effectively applied.

Dr. Marshall Posner is director of head and neck medical oncology and the office of cancer clinical trials at the Tisch Cancer Institute, Mount Sinai School of Medicine, New York. He made these comments in an interview and has no relevant financial conflicts of interest.


 

FROM THE ANNUAL MEETING OF THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY

The HPV prevalence in oropharyngeal cancer significantly increased across the time period, regardless of the assay used, and remained statistically significant, even after correcting for potential loss in assay sensitivity, Dr. Gillison reported. Genotyping with the Inno-LiPA assay appeared to be the most precise, detecting more than a fourfold increase in HPV prevalence from 16.3% in 1984-1989 to 72.7% in 2000-2004.

Median survival was significantly better for patients with HPV-positive cancer at 131 months vs. 20 months for HPV-negative patients (log rank P value less than .001). HPV-positive cases on all assays had a significant reduction in hazard of death compared with HPV-negative cases after adjustment for age, sex, race, registry, calendar period, stage, surgery, chemotherapy, and radiotherapy.

Survival of HPV-positive cases increased over the study period but remained unchanged for HPV-negative cases. Consequently, survival of all oropharyngeal cancer cases improved over time, according to the results of the study, which was led by Dr. Amil Chaturvedi, an investigator with the division of cancer epidemiology and genetics at the National Cancer Institute, Rockville, Md.

Dr. Gillison and Dr. Chaturvedi reported no conflicts of interest. A coauthor disclosed consultancy, research funding, and honoraria from Merck.

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