Cancer Epidemic

When I was in training during the 1980’s, most of the head and neck cancers we encountered were ‘lifestyle’ related.  Typically the patients were smokers and many consumed alcohol on a regular basis as well.  Most of the cancers we diagnosed were in the voice box(larynx).

Over the past several years, we are experiencing a significant increase in head and neck cancer that is unrelated to smoking and drinking.  This epidemic of non-lifestyle related head and neck cancer is due to human papilloma virus(HPV) infection.  A recent study revealed that 11.5 percent of men and 3 percent of women in the U.S. are actively infected with oral HPV.

HPV is a sexually transmitted infection, most commonly contracted during oral sex.  The incidence of HPV infection is higher in those with a greater number of lifetime sexual partners.  In women, HPV infection is the main cause of cervical cancer.  In men, HPV is associated with dramatically increasing incidence of head and neck cancer, particularly in the tonsil region.

Symptoms of HPV associated oral cancer include a persistent sore throat, a growth in the back of the throat, or a lump in the neck.  Anyone experiencing these symptoms should be evaluated by a ear, nose and throat specialist(otolaryngologist).  Fortunately, with prompt diagnosis and appropriate treatment, the prognosis for HPV related head and neck cancer is much better than for ‘lifestyle’ associated head and neck cancer.

It is anticipated that over time, the incidence of HPV related cancer should decrease because of the introduction of the HPV vaccine, Gardasil.  Both boys and girls should be vaccinated with at least 2 doses of Gardasil, starting at age 11 or 12.  Currently, only 60 percent of children are being vaccinated.

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