This Type of Cancer Is on the Rise in Young Adults—Here’s Why
HPV is a suspect in the development of these head and neck tumors.
When you think of the risk factors of head and neck cancer that may affect young people, excessive smoking and drinking may seem like a reasonable connection. After all, 75 percent of these cancers are linked to alcohol and tobacco use.
But a rise in a certain type of head and neck cancer among young adults has nothing to do with drinking or smoking habits.
HPV and Oral Pharynx Cancer: The Surprising Connection
“In the past decade or so, there’s been a remarkable increase in the oral pharynx tumors (cancers that develop in the part of the throat that’s right behind the mouth), where HPV, or human papillomavirus … has been much more commonly involved in the development of these tumors,” says Mark Persky, MD, otolaryngologist and surgeon at NYU Langone Health in New York City. “You’re talking about something that is epidemic proportions that is hitting younger people.” (Learn more about the different types of head and neck cancer.)
HPV is actually a collection of around 200 related viruses, but HPV types 16 and 18 are linked to a higher risk of several types of cancer, including oral pharynx cancer.
The HPV virus can remain dormant in tonsil tissue for many years, but it can become carcinogenic, meaning it can cause cancer to develop, says Dr. Perksy.
HPV is a sexually transmitted infection—the most common in the country, in fact. What’s tricky about this virus, though, is that many people don’t develop any symptoms (so they may not know they have it) but can still infect others through sexual contact.
Can You Get Screened for HPV?
“Screening for HPV is very difficult,” says Dr. Persky. “There’s no simple blood test that can pick up HPV infections.”
The only way to identify HPV is to examine the tissue, which would require an extensive biopsy. You can have a microscopic presence of oral pharynx cancer, yet have significant lymph node involvement, says Dr. Persky. “And that’s typical for HPV-positive oral pharynx tumors.”
How to Lower Your Risk of HPV-Positive Cancers
You can lower your risk of an HPV infection by getting the HPV vaccine (if you’re eligible), using condoms during sex, and getting regular pap tests and HPV tests to stay informed about your health.
“HPV vaccines … should be promoted by primary care physicians for children, before they develop any sort of sexual contact (ideally around age 11 or 12), to protect them from infection and subsequent cancers that develop secondary to the HPV infection,” says Dr. Persky. “I think that’s a national initiative that should be certainly stressed.”
It’s important for you to be aware of all the risk factors and how you can lower your risk for head and neck cancer—whether you have control over them or not. Your doctor can help you understand your status and help you manage your risk of head and neck cancer.
Dr. Persky is an otolaryngologist and surgeon at NYU Langone Health in New York City.
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In the past decade or so,
there's been a remarkable increase in
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the oropharynx tumors where HPV or
Human Papillomavirus has been much more
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commonly involved in
the development of these tumors.
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It is a sexually spread disease
as far as the HPV is concerned.
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So it's becoming much more common,
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especially in the younger
patient population.
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The HPV virus can remain dormant
in tonsil tissue in that area for
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many years, but
access what they call a carcinogenesis.
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In other words, can incite a cancer or
carcinoma to develop.
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And there are different strains,
and the most common strains, and
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the most dangerous strains,
are type 16 and 18.
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And that's the type that most often is
associated with oral pharynx cancers,
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as well as in women, cervical cancers.
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Screening for HPV is very difficult,
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because there's no simple blood test
that can pick up HPV infections.
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The only way to identify is actual
examination of the tissue and
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that required biopsies.
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And we actually have to do
extensive biopsies of the throat,
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'cause you can have
a microscopic primary site, and
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yet significant lymph node
involvement with metastatic disease.
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And that's typical for
HPV-positive or a pharynx tumor.
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I see it all the time.
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This is very very common.
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We are talking about something that is
epidemic proportions that is hitting
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younger people whereas traditionally
it's an older patient population for
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oropharynx carcinomas.
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Now, we have younger patients being
involved with no history of smoking or
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drinking developing significant
lymph node involvement in
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the neck from these HPV associated tumors.
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And that's something
that has to be addressed,
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and it's an evolution in the diagnosis and
the treatment of these lesions.
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Epidemiology and risk factors for head and neck cancer. Waltham, MA: UpToDate, 2019. (Accessed on April 25, 2019 at https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-head-and-neck-cancer.)
Head and neck cancers. Bethesda, MD: National Cancer Institute, 2017. (Accessed on April 25, 2019 at https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet#q2)
How can I make sure I don’t get or spread HPV? Washington, DC: Planned Parenthood. (Accessed on April 25, 2019 at https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hpv/how-can-i-make-sure-i-dont-get-or-spread-hpv)
If you have head and neck cancer. Atlanta, GA: American Cancer Society, 2018. (Accessed on April 25, 2019 at https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/if-you-have-head-or-neck-cancer.html)