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HPV Associated Oropharyngeal Cancer. Benjamin L. Judson, M.D. 10/ 19/ 2013. No conflict of interest. Benjamin L. Judson, M.D. 10/ 19/ 2013. HPV in the Head & Neck. Types 6 and 11 R ecurrent respiratory papillomatosis Types 16 and 18 Previously no role in head & neck. - PowerPoint PPT Presentation
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Author : Updated :
HPV Associated Oropharyngeal Cancer
Benjamin L. Judson, M.D.10/19/2013
333 Cedar StreetNew Haven, Connecticut 06510
Author : Updated :
No conflict of interest.
Benjamin L. Judson, M.D.10/19/2013
3.3.
• Types 6 and 11– Recurrent respiratory papillomatosis
• Types 16 and 18 – Previously no role in head & neck
HPV in the Head & Neck
4.4. Head & Neck Cancer
melanoma thyroid oral cavity, pharynx,
larynx
lymphoma colon lung0
50000
100000
150000
200000
250000deaths new cases
Cancer Facts and Figures 2011, American Cancer Society
5.
Oropharynx-tonsils-base of tongue
Larynx
Nasopharynx
Hypopharynx
Oral Cavity
6.6. Smoking Prevalence: 1965 - 2005
7.7. Different Incidence
Chaturvedi AK, et al. J Clin Oncol 2008; 26: 612–19.
Oropharynx
Oral Cavity, Larynx, Nasopharynx, Hypopharynx
8.8.
Chaturvedi A K et al. JCO 2011;29:4294-4301
Increase in HPV Associated Oropharyngeal Cancer
9.9.
Pytynia KB et al. Oral Oncol. 2014 Jan 21.
10.
Oropharynx-tonsils-base of tongue
Larynx
Nasopharynx
Hypopharynx
Oral Cavity
11.11. Changing Face of Head and Neck Cancer
Sturgis EM, Cinciripini PM. Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer. 2007 Oct 1;110(7):1429-35. Review.
12.12.
• Risk increases with number of lifetime – vaginal-sex partners (26 or more) – oral-sex partners (6 or more)
Different Risk Factors
D’Souza et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007; 356:1944–1956.Sikora AG et al. Bidirectional association of anogenital and oral cavity/pharyngeal carcinomas in men. Arch Otolaryngol Head Neck Surg. 2009 135(4):402-5.
13.13.
Smaller primary tumor
Different Presentation
Straetmans JM et al. Laryngoscope. 2009 Oct;119:1951-7.Gillison ML et al. JNCI. 2008;100(4):261-269.
Bulky/cystic nodal metastasis
14.14.
• Trans oral vizualization is limited:
Different Presentation
15.15. Different Histology
Basaloid poorly
differentiated
P16 + HPV +
16.16. Different Survival
Ang KK et al. N Engl J Med 2010;363:24-35
17.17. Different Risk with Tobacco Exposure
Ang KK et al. N Engl J Med 2010;363:24-35
18.18.
• HPV is causing an epidemic of oropharynx cancer
• Affects men more than women
• Risk of HPV causing oropharynx cancer surpassing that of cervical cancer
Conclusion
19.19.
• Thank you!