Human Papillomavirus-Related Oropharyngeal Carcinoma: Update on Etiology, Management and the Role of Oral Health Care Providers.

BACKGROUND

The role of oncogenic subtypes of the human papillomavirus (HPV) in the pathogenesis of cervical dysplasia, cervical cancer, anal intraepithelial neoplasia, penile intraepithelial neoplasia, vaginal intraepithelial neoplasia and oropharyngeal carcinomas (OPC) is well documented. The classification and management of HPV-positive OPC (HPV+ OPC) has been modified because of differences in the molecular, biological and clinical behaviour of this disease compared with HPV-negative OPC (HPV- OPC) and conventional oral squamous cell carcinoma (OSCC).

DESCRIPTION: HPV+ OPC is associated with significant morbidity, mortality and cost burden on individual patients and the health care system. Preventive measures and efficient screening programs aim to reduce this burden, and oral health care providers are expected to play a pivotal role in this context. Just as they are involved in tobacco and alcohol counseling and cessation, they should support such public health initiatives as HPV screening, detection of potentially premalignant and malignant lesions, patient education about the risk of HPV infection and promotion of HPV vaccination.

PRACTICAL IMPLICATIONS: The advent of HPV vaccines has modified the epidemiologic landscape and the management of cervical dysplasia and cancer. Similar changes are expected with HPV+ OPC. In this paper, we review HPV+ OPC and discuss how oral health care providers can be effectively involved in the fight against this disease.