Oropharyngeal carcinoma related to human papillomavirus

doi:10.1136/bmj.c1439

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Hisham Mehanna, director 1,
Terence M Jones, reader2,
Vincent Gregoire, professor3,
K Kian Ang, professor4

¹Institute of Head and Neck Studies and Education (InHANSE), University Hospital, Coventry CV2 2DX
²Liverpool CR-UK Cancer Centre, School of Cancer Studies, Division of Surgery and Oncology, University of Liverpool, Liverpool L69 3GA
³Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, Université Catholique de Louvain, 1200 Brussels, Belgium
⁴Department of Radiation Oncology, University of Texas, MD Anderson Cancer Centre, Houston, TX 77030, USA

hisham.mehanna{at}uhcw.nhs.uk

Incidence is increasing rapidly, with implications for prognosis and policy

Head and neck cancer is the sixth most common cancer, with about 640?000 new cases each year worldwide. Despite an overall marginal decline in the incidence of most head and neck cancers in recent years,1 the incidence of oropharyngeal squamous cell carcinoma has increased greatly, especially in the developed world. In the United States, the incidence of oropharyngeal squamous cell carcinoma increased by 22% from 1.53 per 100?000 to 1.87 per 100?000 between 1999 and 2006, after showing no change between 1975 and 1999.1 The United Kingdom has seen a 51% increase in oral and oropharyngeal squamous cell carcinoma in men from seven per 100?000 to 11 per 100?000 between 1989 and 2006.2

The increase in incidence of oropharyngeal squamous cell carcinoma seems to be accounted for by a rise in human papillomavirus (HPV) related oropharyngeal carcinoma. A recent retrospective study showed a progressive proportional increase in the detection of HPV in biopsies taken to diagnose oropharyngeal squamous cell carcinoma in the Swedish county of Stockholm over the past three decades (23.3% in 1970s, 29% in 1980s, 57% in 1990s, 68% between …