FDA-Approved Vaccines Can Prevent HPV-Related Oropharyngeal Cancers

Human papillomavirus is the most common sexually transmitted infection in men and women in the United States, according to the Centers for Disease Control and Prevention. Nearly 80 million people -- about 1 in 4 -- are currently infected in the United States. Most people get HPV infections shortly after becoming sexually active for the first time, according to the National Cancer Institute.

HPV comprises a large group of related viruses; each type of virus is given a number. Low-risk HPV types are not harmful to people, and the body's immune system can fight off the virus in some cases. High-risk strains can cause serious health problems, including certain cancers.

The virus strains that infect the genital areas can infect the mouth and throat (oral HPV) and can be transmitted through oral sex. The low-risk types can cause warts in the mouth or throat. High-risk HPV includes type 16 and 18; they can cause cancer of the head and neck area -- similar strains have been implicated for cervical cancers, vaginal cancers and anal cancers. Once a person gets infected by a high-risk HPV, the cancer can take years to develop. Not all individuals infected will necessarily progress to development of cancer.

Cancers in the back of the throat, most commonly in the base of the tongue and tonsils, are located in an area known as the "oropharynx." These cancers are called "oropharyngeal cancers." Anywhere from 60 to 80 percent of these cancers are thought to be caused by high-risk human papilloma virus type 16.

Cancers of the oropharynx are about three times more common in men than women, and the incidence is especially seen in those ages 40 to 80, but can also be seen as early as 25 to 40 years of age.

The best way to diagnose oropharyngeal cancers is via a thorough head and neck examination by an ear, nose and throat surgeon. Typically, people will have either a neck mass or, less frequently, an abnormal sensation in the back of the throat. If you have a neck lump or an abnormal sensation in the back of the throat that lasts one to two weeks, it should prompt a visit to your primary care doctor. If the symptoms persist beyond a few weeks, it should trigger a referral to an ear, nose and throat surgeon.

Advanced stages of oropharyngeal cancer are defined as the spread of the cancer to the lymph nodes in the neck or larger primary tumors. Treatments for these cancers include some combination of surgery, radiation therapy and chemotherapy, the details of which will vary depending on the exact staging and location of the tumor.

Vaccines approved by the Food and Drug Administration target high-risk HPV strains before individuals are exposed to the virus strains -- one targets high-risk HPV (16 and 18), whereas the other vaccines target both high-risk and low-risk HPV.

Despite the proven safety of the HPV vaccines, a low compliance rate remains. The Advisory Committee on Immunization Practices recommends routine vaccination with either of the vaccines for females ages 11 or 12 and for males ageds11 or 12. It is also recommended for females 13 to 26 and males 13 to 26 who have not been previously vaccinated.

Thanks to community outreach, testimonials and public education, more people are becoming aware of HPV, HPV-related cancers and the available FDA-approved vaccines.

Eric Lamarre, MD, is a head and neck surgeon specializing in head and neck cancers at Cleveland Clinic.