HJBR May/Jun 2021

46 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF BATON ROUGE ONCOLOGY HEAD AND NECK CANCER refers to ma- lignancies affecting the lining of the nose, sinus, mouth, throat and, less common- ly, the salivary glands. These cancers ac- count for approximately 4% of all malig- nancies diagnosed in the U.S. each year. In 2021, it is estimated that more than 66,000 people will be diagnosed with head and neck cancer and 14,000 will succumb to this devastating disease. His- torically, tobacco and alcohol consump- tion have been closely linked to the de- velopment of head and neck squamous cell carcinoma, the most common variety of head and neck cancer. Due in no small part to public health efforts to reduce to- bacco use nationwide, the overall inci- dence of head and neck squamous cell carcinoma has been decreasing over the last several decades. growths. In addition to oropharyngeal cancer, HPV is implicated in the develop- ment of cervical cancer, genital warts and papilloma. The incidence of oropharyngeal cancer caused by HPV has continued to increase for the last several decades, including a 225% increase between 1988 and 2004. It is now estimated that 90% of all cancers originating from the oropharynx are related to HPV. Patients diagnosed with HPV-related oropharyngeal cancer tend to be younger (50-60 years old), have fewer traditional risk factors for head and neck cancer (tobacco use or alcoholism) and are healthier than patients with tobacco- and alcohol-related head and neck cancers. Thankfully, these cancers also carry a more favorable prognosis than their tobacco- and alcohol-related counterparts. COLUMN ONCOLOGY Since the late 1990s, however, the inci- dence of oropharyngeal cancer has been increasing. This rise in oropharyngeal cancers, or cancers from the back of the throat (tonsils, base of tongue and pha- ryngeal wall), has been driven largely by the Human Papillomavirus, or HPV. HPV AND OROPHARYNGEAL CANCER HPV is the most common sexually trans- mitted infection in the world. While it is im- possible to determine howmany people are exposed to HPV annually, it has been esti- mated up to 75% of the adult population of the United States has been exposed to HPV, and at any one time 10% of adult men and 3% of adult women have detectable HPV in their mouth or throat. Most HPV infections are eliminated by the immune system, but in some people, HPV persists and leads to cancerous or precancerous A GROWING PROBLEM HPV-relatedHead and Neck Cancer: