Role of Human Papilloma Virus in Head And Neck Malignancy

Abstract

Human papilloma virus has been routinely implicated in the carcinogenesis of uterine cervix, vagina, vulva and anal region. Recently over the past two decades, it has been found that HPV virus is also responsible for the carcinoma of tonsil and base tongue region in the oropharynx. Interestingly the main viral strain that is involved in carcinogenesis of uterine cervix and oropharyngeal region is HPV 16. Currently, the incidence of oropharyngeal malignancy is increasing alarmingly and more than 80% of such malignancies are due to high risk HPV virus infection. So a literature review was done to analyse data on disease prevalence, disease behaviour and treatment outcome of HPV positive Head & Neck malignancy. It was found that unlike non HPV related Head & Neck carcinoma which usually affects older age group, HPV positive head and neck malignancy tend to affect younger age group. Individuals with HPV positive oropharyngeal malignancy tend to have oral sex and have multiple sexual partners. Such sexual practice, explains the reason for the confinement of HPV positive malignancy mainly to the oropharyngeal region in head and neck. Tumour has less aggressive course and they show better response to treatment. Overall the tumour affects younger individuals and shows better treatment response. All these favourable factors have opened up scope for treatment de-intensification, targeted therapy and cancer prevention using HPV vaccine.