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February 2017

Human Papillomavirus–Associated Oropharyngeal Cancer: Not Just White Men Anymore

Author Affiliations
  • 1Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston
  • 2Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe
  • 3Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
JAMA Oncol. 2017;3(2):161-162. doi:10.1001/jamaoncol.2016.3510

Previous infection with human papillomavirus (HPV), in particular HPV type 16, is causally associated with oropharyngeal carcinoma (OPC).1 An epidemic of OPC has been noted and attributed to HPV, with the United States experiencing a significant increase in the incidence of HPV-associated OPC since the mid-1990s.1,2 As the incidence of HPV-associated OPC continues to increase, critical needs in the field include novel means to identify high-risk groups to facilitate screening and OPC diagnosis at earlier stages because more than 80% of the patients present with stage IV disease. For risk stratification, our understanding of population trends suggests that men, in particular middle-aged white men of middle to high socioeconomic status, are disproportionately affected by the rising epidemic.3,4 We also need better ways to stratify patients who already have HPV-associated OPC; current efforts include refinements to the staging system specific to HPV-associated OPC, as well as using HPV and/or p16 status and smoking status to select patients for dose de-escalation therapeutic clinical trials.5,6