Click here to view/download a PDF of the CDC’s “HPV and Oropharyngeal Cancer – Fact Sheet”
Head and neck cancer includes cancers of the mouth, nose, sinuses, tonsils, salivary glands, throat, and lymph nodes in the neck. Most begin in the moist tissues that line the mouth, nose and throat.
New cases: An estimated 45,780 new cases of cancer of the oral cavity and pharynx (throat) are expected in 2015. Incidence rates are more than twice as high in men as in women. From 2007 to 2011, incidence rates among whites increased in men by 1.3% per year and were stable as is in women; in contrast, among blacks rates declined by 3.0% per year in men and by 1.4% per year in women. The increase among white men is driven by a subset of cancers in the oropharynx, including the base of the tongue and the tonsils, that are associated with human papillomavirus (HPV) infection.
Squamous cell cancer of the head and neck is one of the most common cancers worldwide. It constitutes about 4% of all cancers in the United States and 5% in the United Kingdom
Deaths: An estimated 8,650 deaths from oral cavity and pharynx cancer are expected in 2015. Death rates have been decreasing over the past three decades, partly due to the downturn in the smoking epidemic. However, from 2007 to 2011, while rates continued to decrease in women (by 2.0% per year), they stabilized in men.
Signs and symptoms: Symptoms may include a lesion in the throat or mouth that bleeds easily and does not heal; a persistent red or white patch, lump, or thickening in the throat or mouth; ear pain; a neck mass; or coughing up blood. Difficulty chewing, swallowing, or moving the tongue or jaws are often late symptoms.
Risk factors: HPV infection of the mouth and throat, believed to be transmitted through sexual contact, increases risk. HPV is the most common sexually transmitted infection in the United States. About 79 million Americans are currently infected with HPV and about 14 million people become newly infected each year. HPV is so common that most sexually-active men and women will get at least one type of HPV at some point in their lives. As a result, the incidence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC), which is both biologically and clinically distinct from tobacco- and alcohol-related OPSCC, is dramatically increasing. The finding that individuals with HPV-positive local/regionally advanced OPSCC have a significantly better prognosis than their negative counterparts have led to efforts to de-escalate treatment in those patients to avoid serious side effects and to improve their long-term quality of life, while maintaining treatment efficacy. Other known risk factors include tobacco use in any form (smoked and smokeless) and excessive alcohol consumption. Many studies have reported a synergistic relationship between smoking and alcohol that results in a 30-fold increased risk for individuals who both smoke and drink heavily.
Early detection: Cancer can affect any part of the oral cavity, including the lip, tongue, mouth, and throat. Visual inspection by dentists and physicians can often detect premalignant abnormalities and cancer at an early stage, when treatment may be less extensive and more successful.
Treatment: Radiation therapy and surgery, separately or in combination, are standard treatments; chemotherapy is added for advanced disease. Targeted therapy with cetuximab (Erbitux®) may be combined with radiation in initial treatment or used to treat recurrent cancer.
Survival: The 5- and 10-year relative survival rates for people with cancer of the oral cavity or pharynx are 63% and 51%, respectively. Less than one-third (31%) of cases are diagnosed at a local stage, for which 5-year survival is 83%.