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HPV Associated Oropharyngeal Cancer

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.

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HPV Associated Oropharyngeal Cancer

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  1. HPV Associated Oropharyngeal Cancer • Benjamin L. Judson, M.D. • 10/19/2013 333 Cedar StreetNew Haven, Connecticut 06510

  2. No conflict of interest. • Benjamin L. Judson, M.D. • 10/19/2013

  3. HPV in the Head & Neck • Types 6 and 11 • Recurrent respiratory papillomatosis • Types 16 and 18 • Previously no role in head & neck

  4. Head & Neck Cancer Cancer Facts and Figures 2011, American Cancer Society

  5. Nasopharynx Oral Cavity Oropharynx -tonsils -base of tongue Larynx Hypopharynx

  6. Smoking Prevalence: 1965 - 2005

  7. Different Incidence Oral Cavity, Larynx, Nasopharynx, Hypopharynx Oropharynx Chaturvedi AK, et al. J ClinOncol 2008; 26: 612–19.

  8. Increase in HPV Associated Oropharyngeal Cancer Chaturvedi A K et al. JCO 2011;29:4294-4301

  9. PytyniaKB et al. Oral Oncol. 2014 Jan 21.

  10. Nasopharynx Oral Cavity Oropharynx -tonsils -base of tongue Larynx Hypopharynx

  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. Different Risk Factors • Risk increases with number of lifetime • vaginal-sex partners (26 or more) • oral-sex partners (6 or more) 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. Different Presentation Smaller primary tumor • Bulky/cystic nodal metastasis Straetmans JM et al. Laryngoscope. 2009 Oct;119:1951-7. Gillison ML et al. JNCI. 2008;100(4):261-269. 

  14. Different Presentation • Trans oral vizualization is limited:

  15. Different Histology Basaloid poorly differentiated • P16 + • HPV +

  16. Different Survival Ang KK et al. N Engl J Med 2010;363:24-35

  17. Different Risk with Tobacco Exposure Ang KK et al. N Engl J Med 2010;363:24-35

  18. Conclusion • HPV is causing an epidemic of oropharynx cancer • Affects men more than women • Risk of HPV causing oropharynx cancer surpassing that of cervical cancer

  19. Thank you!

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