As the medical community recognizes April as Oral Cancer Awareness Month, the Head and Neck Cancer Alliance notes that more than 650,000 cases of these diseases will be diagnosed worldwide in 2018, which could lead to more than 14,000 deaths in the United States. The Icahn School of Medicine at Mount Sinai and Johns Hopkins University aim to change these numbers with a study exploring how risk factors affect oral HPV infection rates.
While tobacco and alcohol consumption are major contributors to oral cancer, HPV is driving increased rates, particularly among younger men who don’t smoke. HPV cases now make up about 70% of all tonsil- and tongue-based cancers in the United States, the Icahn School reports, and the Centers for Disease Control and Prevention estimates that more than 16,000 HPV-associated oropharyngeal cancers are diagnosed each year in the United States.
The first of its kind, the study will screen patients who may have been exposed to high-risk HPV but have no evidence of cancer. Currently, there is no screening for head and neck HPV, but the researchers hope to change that by determining which patients have been exposed to high-risk HPV and need closer follow-up.
The researchers will take samples of the subjects’ blood, saliva, and urine to test them for HPV antibodies. If they test positive for high-risk antibodies, they will be monitored annually for the next five years and given information about the signs and symptoms that may indicate an HPV-related cancer. The goal of the study is to examine the natural history of HPV exposure and how different behaviors affect the risk of acquiring a high-risk HPV infection.
“We are very excited to be participating in this groundbreaking study and hope that in the future the information obtained from this study allows us to thoughtfully screen and counsel patients on their risk of head and neck cancer related to high-risk HPV,” said Brett Miles, MD, co-chief of the Division of Head and Neck Oncology for the Mount Sinai Health System and associate professor of otolaryngology at the Icahn School of Medicine.
Known as Men/Women Offering Understanding of Throat HPV or MOUTH, the multisite study is looking for subjects. Criteria include:
- Men ages 35 to 69
- Women and/or partners of women with known cervical dysplasia
- Partners of patients who have HPV and oropharyngeal cancer
- People who have had three or more oral sex partners in their lifetime
- People who have never had head or neck cancer
- People who are willing to come back for annual follow-up visits if they are positive for high-risk HPV
Meanwhile, the Icahn School of Medicine is offering free oral, head, and neck cancer screenings in conjunction with the Head and Neck Cancer Alliance on Thursday, April 12 from 10 am to 2 pm at the Mount Sinai Hospital in New York City. Each 15-minute screening will include an examination of the neck and an inspection of the oropharynx and mouth. No registration, appointment, or preparation is necessary.
“The treatment of head and neck cancer generally includes surgery, radiation, and chemotherapy, depending on the cancer. While many different treatment options exist depending on the stage and type of cancer, one thing is clear: early detection leads to higher cure rates and improved outcomes for all types of head and neck cancer,” said Miles.
The school notes that smokers generally develop head and neck cancer in their 60s and that men are twice as likely as women to be affected because of smoking patterns and HPV risks. Initial symptoms include a sore in the mouth that doesn’t heal, a sore throat, trouble swallowing, lumps or patches in the mouth, changes in voice, and a lump in the neck. Also, 50% of people with head and neck cancers have very advanced cases by the time they see a doctor.
“It is very important to get a screening if you are in a high-risk group, namely smokers, moderate to heavy alcohol users, and those who have a history of oral sex with multiple partners,” said Miles. “These are the groups at the highest risk for head and neck cancer.”
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