title: The connection between human papillomavirus and oropharyngeal squamous cell carcinomas in the United States: implications for dentistry.
abstract: BACKGROUND
  Results from studies conducted in the past several years suggest that some oropharyngeal cancers, those of the base of the tongue and the tonsils, are associated with high-risk types of human papillomavirus (HPV). In this article, the authors summarize the available evidence regarding the epidemiology of HPV-associated oropharyngeal cancers in the United States, the available HPV vaccines and the implications of these for dentistry. They also examine the differences in HPV prevalence between cancers of the oral cavity and those of the oropharynx.
  
  
  METHODS
  The authors searched PubMed, Web of Science, The Cochrane Library and the National Guideline Clearinghouse to identify English-language systematic reviews and meta-analyses focused on HPV-associated oropharyngeal squamous cell cancers published from January 2005 through May 2011.
  
  
  RESULTS
  Molecular and epidemiologic evidence suggest a strong etiologic association of HPV with oropharyngeal cancers. The incidence of oropharyngeal cancers in the United States has increased between 1973 and 2007, whereas that of cancers at other head and neck sites has decreased steadily. Compared with HPV-negative cancers, HPV-positive oropharyngeal cancers are associated with certain sexual behaviors, occur more often among white men and people who do not use tobacco or alcohol, and may occur in a population younger by about four years (median ages, 52-56 years). Despite often having a later stage of diagnosis, people with HPV-positive oropharyngeal cancers have a lower risk of dying or recurrence than do those with HPV-negative cancers. The effectiveness of the HPV vaccine in preventing oropharyngeal cancers is unknown.
  
  
  CONCLUSIONS
  Dental health care personnel (DHCP) should be knowledgeable about the role of HPV in carcinogenesis, the association of HPV with oropharyngeal cancers and HPV vaccines, and they should be prompt in referring patients with suggestive symptoms for evaluation. DHCP can play an important role in increasing patients' knowledge about HPV and oropharyngeal cancers.
authors.affiliation: Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, MS F-10, 4770 Buford Highway, Atlanta, Ga. 30341, USA. JLCleveland@cdc.gov
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Cleveland
authors.forename: Michele L
authors.initials: ML
authors.lastname: Junger
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Dunne
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
mesh_terms: D000367:Age Factors; D052685:Alphapapillomavirus / Q000502:physiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D015994:Incidence; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000821:virology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000821:virology*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D053918:Papillomavirus Vaccines; D012307:Risk Factors; D012725:Sexual Behavior; D014481:United States / Q000453:epidemiology
chemical_list: D053918:Papillomavirus Vaccines