Abstract
Objectives: To explore unique characteristics of HPV related oral malignant and premalignant lesions and to describe role of dental surgeons in prevention of this viral- induced carcinogenesis.
Methods: Extensive literature search was conducted to identify articles detailing HPV associated diseases. Data collected were categorised under relevant titles of clinical interest.
Results: Peculiarities of HPV linked cancers in head and neck include its different mode of transmission, younger age distribution, irrelevant habit history, good treatment response, better survival rates, less chance of local recurrence and low distant metastasis.
Conclusions: The most distinguishing feature of HPV related head and neck cancers is that it is vaccine preventable. Dental surgeons have got an influential role in creating patient awareness regarding this emerging epidemic. The article advocate further research in this regard.
Key Message: The carcinogenic potential of Human papilloma virus has been an interesting topic of research for the past few decades. This article discusses the recent epidemiologic and etiologic trends in Human Papilloma Virus – associated head and neck cancers, its presence in precancerous lesions and its implication in dental practise.
Keywords: Human papilloma virus, Head and neck cancers, Viral carcinogenesis
References
- Inglehart RC, Taberna M, Pickard RKL, Hoff M, Fakhry C, Ozer E, et al. HPV knowledge gaps and information seeking by oral cancer patients. Oral Oncol. 2016;63:23–9.
- Gillison ML, Chaturvedi AK, Anderson WF, Fakhry C. Epidemiology of Human Papillomavirus–Positive Head and Neck Squamous Cell Carcinoma. J Clin Oncol. 2015;33:3235–42.
- Pytynia KB, Dahlstrom KR, Sturgis EM. Epidemiology of HPV-associated oropharyngeal cancer. Oral Oncol. 2014;50:380–6.
- Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, et al., editors. AJCC Cancer Staging Manual [Internet]. 8th ed. Springer International Publishing; 2017 [cited 2018 Sep 27]. Available from: //www.springer.com/in/book/9783319406176
- Shope RE, Hurst EW. Infectious Papillomatosis of Rabbits. J Exp Med. 1933;58:607–24.
- de Villiers E-M, Fauquet C, Broker TR, Bernard H-U, zur Hausen H. Classification of papillomaviruses. Virology. 2004;324:17–27.
- Genner J, Scheutz F, Ebbesen P, Melbye M. Antibody to human papilloma virus in Danish dentists. Eur J Oral Sci. 1988;96:118–120.
- Achour M, Zeghal D, Kochbati L, Kahla S, Zouari F, Maâlej M, et al. Antibody response for L1, E6, E7 HPV 16, and HPV 18 antigens in Tunisian women with cervical cancer. J Immunoassay Immunochem. 2009;30:82–96.
- International Agency for Research on Cancer, editor. IARC monographs on the evaluation of carcinogenic risks to humans, volume 90, Human papillomaviruses: this publication represents the views and expert opinions of an IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, which met in Lyon, 15 - 22 February 2005. Lyon: IARC; 2007. 670 p.
- Syrjänen K, Happonen R-P, Syrjanen S, Calonius B. Human papilloma virus (HPV) antigens and local immunologic reactivity in oral squamous cell tumors and hyperplasias. Eur J Oral Sci. 1984;92:358–70.
- Niedobitek G, Pitteroff S, Herbst H, Shepherd P, Finn T, Anagnostopoulos I, et al. Detection of human papillomavirus type 16 DNA in carcinomas of the palatine tonsil. J Clin Pathol. 1990;43:918–21.
- Pinidis P, Tsikouras P, Iatrakis G, Zervoudis S, Koukouli Z, Bothou A, Galazios G, Vladareanu S. Human papilloma virus’ life cycle and carcinogenesis. Maedica. 2016 ;11:48.
- Schwartz SM, Daling JR, Madeleine MM, Doody DR, Fitzgibbons ED, Wipf GC, et al. Oral cancer risk in relation to sexual history and evidence of human papillomavirus infection. J Natl Cancer Inst. 1998;90:1626–36.
- Kreimer AR, Villa A, Nyitray AG, Abrahamsen M, Papenfuss M, Smith D, et al. The Epidemiology of Oral HPV Infection among a Multinational Sample of Healthy Men. Cancer Epidemiol Biomarkers Prev. 2011;20:172–82.
- Gillison ML, D’Souza G, Westra W, Sugar E, Xiao W, Begum S, et al. Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst. 2008;100:407–20.
- Sathish N, Wang X, Yuan Y. Human Papillomavirus (HPV)-associated Oral Cancers and Treatment Strategies. J Dent Res. 2014;93:29S–36S.
- Smith EM, Ritchie JM, Summersgill KF, Hoffman HT, Wang DH, Haugen TH, et al. Human papillomavirus in oral exfoliated cells and risk of head and neck cancer. J Natl Cancer Inst. 2004;96:449–55.
- D’Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007;356:1944–56.
- Lindel K, Beer KT, Laissue J, Greiner RH, Aebersold DM. Human papillomavirus positive squamous cell carcinoma of the oropharynx: a radiosensitive subgroup of head and neck carcinoma. Cancer. 2001;92:805–13.
- Schäfer A, Friedmann W, Mielke M, Schwartländer B, Koch MA. The increased frequency of cervical dysplasia-neoplasia in women infected with the human immunodeficiency virus is related to the degree of immunosuppression. Am J Obstet Gynecol. 1991;164:593–9.
- Vermund SH, Kelley KF, Klein RS, Feingold AR, Schreiber K, Munk G, et al. High risk of human papillomavirus infection and cervical squamous intraepithelial lesions among women with symptomatic human immunodeficiency virus infection. Am J Obstet Gynecol. 1991;165:392–400.
- National Center for Immunization and Respiratory Disease. HPV Vaccine Information for Clinicians [Internet]. Centres for Disease Control and Prevention; 2016. Available from: https://www.cdc.gov/hpv/hcp/need-to-know.pdf
- Westra WH. The Changing Face of Head and Neck Cancer in the 21st Century: The Impact of HPV on the Epidemiology and Pathology of Oral Cancer. Head Neck Pathol. 2009;3:78–81.
- Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol Off J Am Soc Clin Oncol. 2011;29:4294–301.
- Nguyen NP, Nguyen LM, Thomas S, Hong-Ly B, Chi A, Vos P, et al. Oral sex and oropharyngeal cancer: The role of the primary care physicians. Medicine (Baltimore). 2016;95:e4228.
- Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155:97–107.
- Ledford CJW, Cafferty LA, Russell TC. The Influence of Health Literacy and Patient Activation on Patient Information Seeking and Sharing. J Health Commun. 2015;20:77–82.
- Daley E, Dodd V, DeBate R, Vamos C, Wheldon C, Kline N, et al. Prevention of HPV-related oral cancer: assessing dentists’ readiness. Public Health. 2014;128:231–8.
- Yacobi E, Tennant C, Ferrante J, Pal N, Roetzheim R. University students’ knowledge and awareness of HPV. Prev Med. 1999;28:535–41.
- Licitra L, Perrone F, Bossi P, Suardi S, Mariani L, Artusi R, et al. High-Risk Human Papillomavirus Affects Prognosis in Patients With Surgically Treated Oropharyngeal Squamous Cell Carcinoma. J Clin Oncol. 2006;24:5630–6.
- Sannigrahi M, Singh V, Sharma R, Panda N, Radotra B, Khullar M. Detection of active human papilloma virus-16 in head and neck cancers of Asian North Indian patients. Oral Dis. 2016;22:62–8.
- Lassen P, Eriksen JG, Hamilton-Dutoit S, Tramm T, Alsner J, Overgaard J. Effect of HPV-Associated p16 INK4A Expression on Response to Radiotherapy and Survival in Squamous Cell Carcinoma of the Head and Neck. J Clin Oncol. 2009;27:1992–8.
- Ibieta BR, Lizano M, Frı́as-Mendivil M, Barrera JL, Carrillo A, Ma. Ruı́z-Godoy L, et al. Human papilloma virus in oral squamous cell carcinoma in a Mexican population. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontology. 2005;99:311–5.
- Bijina BR, Ahmed J, Shenoy N, Ongole R, Shenoy S, Baliga S. Detection of human papilloma virus in potentially malignant and malignant lesions of the oral cavity and a study of associated risk factors. South Asian J Cancer. 2016;5:179–81.
- Reed SG, Wahlquist AE. Adults With Oral High-risk Human Papillomavirus (HPV) and/or Smoking History Have a Higher Risk for Clinically Diagnosed Oral Premalignant Lesions. J Evid Based Dent Pract. 2015;15:134–6.
- Campisi G, Giovannelli L, Aricò P, Lama A, Di Liberto C, Ammatuna P, et al. HPV DNA in clinically different variants of oral leukoplakia and lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontology. 2004;98:705–11.
- Giovannelli L, Campisi G, Lama A, Giambalvo O, Osborn J, Margiotta V, et al. Human papillomavirus DNA in oral mucosal lesions. J Infect Dis. 2002;185:833–36.
- Lind PO, Syrjänen SM, Syrjänen KJ, Koppang HS, ASS E. Local immunoreactivity and human papillomavius (HPV) in oral precancer and cancer lesions. Eur J Oral Sci. 1986;94:419–26.
- Kumar R, Rai AK, Das D, Das R, Kumar RS, Sarma A, et al. Alcohol and Tobacco Increases Risk of High Risk HPV Infection in Head and Neck Cancer Patients: Study from North-East Region of India. Chang JS, editor. PLOS ONE. 2015 Oct 16;10:e0140700.
- Jitani AK, Raphael V, Mishra J, Shunyu NB, Khonglah Y, Medhi J. Analysis of human papilloma virus 16/18 DNA and its correlation with p16 expression in oral cavity squamous cell carcinoma in North-Eastern India: A chromogenic in-situ hybridization based study. Journal of clinical and diagnostic research: JCDR. 2015;9:EC04.
- Dahlstrom KR, Little JA, Zafereo ME, Lung M, Wei Q, Sturgis EM. Squamous cell carcinoma of the head and neck in never smoker–never drinkers: A descriptive epidemiologic study. Head Neck. 2008 ;30:75–84.
- Zhang Z-Y, Sdek P, Cao J, Chen W-T. Human papillomavirus type 16 and 18 DNA in oral squamous cell carcinoma and normal mucosa. Int J Oral Maxillofac Surg. 2004;33:71–4.
- Lohaus F, Linge A, Tinhofer I, Budach V, Gkika E, Stuschke M, et al. HPV16 DNA status is a strong prognosticator of loco-regional control after postoperative radiochemotherapy of locally advanced oropharyngeal carcinoma: Results from a multicentre explorative study of the German Cancer Consortium Radiation Oncology Group (DKTK-ROG). Radiother Oncol. 2014;113:317–23.
- Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, et al. Improved Survival of Patients With Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma in a Prospective Clinical Trial. JNCI J Natl Cancer Inst. 2008;100:261–9.
Corresponding Author
Dimla Denny Cheruvathoor
Junior Resident, Department of Oral Medicine and Radiology, Government Dental College, Kozhikode, Kerala, India
Phone number- 9495854948, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.