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December 16, 2021

Population Trends and Long-term Outlook for Oropharyngeal Cancer: Have We Found a Silver Lining?

Author Affiliations
  • 1Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
  • 2Duke Cancer Institute, Duke University, Durham, North Carolina
  • 3Editorial Board Member, JAMA Otolaryngology–Head & Neck Surgery
  • 4The VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vermont
  • 5Section of Otolaryngology–Head and Neck Surgery, the Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
  • 6Associate Editor, JAMA Otolaryngology–Head & Neck Surgery
JAMA Otolaryngol Head Neck Surg. 2022;148(2):97-98. doi:10.1001/jamaoto.2021.3786

A decade ago, a seminal study in the oropharyngeal cancer field1 reported that there had been a 225% increase in incidence of human papillomavirus (HPV)-associated oropharyngeal cancer in the US between 1988 and 2004. Crucially, the authors projected that if trends were to continue, HPV-positive oropharyngeal cancer would surpass cervical cancer as the leading HPV-associated cancer in the US by 2020.1 This prediction has since become a reality.2 Between 2012 and 2016, HPV-associated oropharyngeal cancer indeed became the most common HPV-associated cancer in the US, and its incidence has surpassed cervical cancer, the disease for which the HPV vaccine was first developed and marketed.3,4 In this issue of JAMA Otolaryngology–Head & Neck Surgery, the cross-sectional study by Damgacioglu and colleagues5 shines light on the trends in oropharyngeal cancer since the turn of the millennium using a relatively newly publicly available source of national data. They report that oropharyngeal cancer incidence increased nationally in the US between 2001 and 2017, especially among older adults.5

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1 Comment for this article
HPV associated cancer
Daniel Krell, M.D. | Retired PCP
Over recent decades there has been parallel increase in the rates of colorectal cancers in younger cohorts. In lists of proposed risk factors for this increase, HPV infection is rarely noted, if noted at all. It would be instructive to compare the timing of increases in oropharyngeal and colorectal cancers, and follow both curves as recipients of HPV vaccine come of age in the cohorts that are experiencing the increased frequencies of both diseases.

Lowering the age for recommended CRC screening is being discussed. Taking a good sexual history, particularly of receptive anal intercourse, could be
a good way to identify people at risk for early onset CRC and the need for CRC screening of the identified people at younger ages.