In Reply The focus of much current research has been the role of human papilloma virus (HPV) in oropharyngeal cancer, especially as a separate risk factor, or even disease process, compared with smoking-related cancer of the oropharynx. Our data1 support previous research showing that oral cavity cancer is slightly more prevalent than oropharyngeal cancer, and that this disparity is largely due to increased numbers of nonsmokers, especially women, who develop oral cavity cancers. In our series, oral cavity cancers occurred in lifelong nonsmokers in 87 patients compared with only 48 patients with oropharyngeal cancer. Mentioning HPV in the title of our article1 was partly to bring attention to the fact that despite the significant research focus on HPV oropharyngeal cancers, nonsmokers are much more likely to develop oral cavity cancers, and a risk factor more important than HPV may be as yet be unrecognized or underinvestigated.
Perry BJ, Zammit AP, Perry CFL. Bringing Light to Dental Trauma and Oral Cavity Cancer—Reply. JAMA Otolaryngol Head Neck Surg. 2015;141(11):1029-1030. doi:10.1001/jamaoto.2015.2410