Emergent disease may have implications for public health and clinical practice-- Jeff Muise
Friday, March 26, 2010 (Last Updated: 03/29/2010)
FRIDAY, March 26 (HealthDay News) -- Oropharyngeal squamous cell carcinoma related to human papillomavirus (HPV) represents an emergent, distinct, and increasingly prevalent type of head and neck cancer that may ultimately affect public health policy and clinical practice, according to an editorial published March 25 in BMJ.
Hisham Mehanna, M.D., of University Hospital in Coventry, U.K., and colleagues report on disease trends for the past two decades, including a 22-percent increase in oropharyngeal squamous cell carcinoma incidence in the United States from 1999 to 2006, and a 51 percent increase in men in the United Kingdom between 1989 and 2006. The reviewers note that HPV was found in 60 to 80 percent of recent oropharyngeal carcinoma biopsies in U.S. studies, compared to 40 percent in the prior decade. In addition, the increased incidence of HPV-related oropharyngeal squamous cell carcinoma may result from sexual transmission through orogenital intercourse.
There will be public health implications to this increased incidence, the authors write. For example, vaccinating boys for HPV has not been viewed as cost-effective in the past, but may in the future. Also, HPV status may become an important diagnostic and prognostic factor in oropharyngeal carcinoma, and a stratification category in research studies. In addition, HPV-related disease generally has better survival rates than non-HPV-related disease.
"To date, we have no good evidence to support managing patients with HPV-related head and neck cancer differently from those whose tumors are not HPV related, although several studies are being planned to evaluate different treatment options," the authors write.
Two authors reported either being involved with contract work or receiving research grants from pharmaceutical companies.
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