title: The "new" head and neck cancer patient-young, nonsmoker, nondrinker, and HPV positive: evaluation.
abstract: OBJECTIVE
  The near epidemic rise of the incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) presents the practitioner with a "new" head and neck cancer patient, vastly different from those with the traditional risk factors who formed the basis of most practitioners' training experience. Accordingly, a thorough and disease-specific evaluation process is necessitated. This article will review the evaluation of the HPV-related cancer patient, including a review of the HPV-positive oropharyngeal cancer epidemic from the surgeon's perspective, evaluation of the primary lesion, evaluation of the neck mass, and role of imaging, to provide a framework for addressing the challenging questions patients may ask.
  
  
  METHODS
  Available peer-reviewed literature and practice guidelines.
  
  
  METHODS
  Assessment of selected specific topics by authors solicited from the Head and Neck Surgery and Oncology Committee of the American Academy of Otolaryngology-Head and Neck Surgery Foundation and the American Head and Neck Society.
  
  
  CONCLUSIONS
  The dramatic rise in OPSSC related to HPV is characterized by a "new" cancer patient who is younger and lacks traditional risk factors. Today's caregiver must be prepared to appropriately evaluate, counsel, and treat these patients with HPV-positive disease with the expectation that traditional treatment algorithms will evolve to maintain or improve current excellent cure rates while lessening treatment related side effects.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA daniel_deschler@meei.harvard.edu.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Deschler
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Center, Baltimore, Maryland, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Richmon
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Samir S
authors.initials: SS
authors.lastname: Khariwala
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Pittsburgh University Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Marilene B
authors.initials: MB
authors.lastname: Wang
mesh_terms: D000328:Adult; D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000628:therapy / Q000821:virology*; D004326:Drinking; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000628:therapy / Q000821:virology*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D018570:Risk Assessment; D012907:Smoking; D014481:United States / Q000453:epidemiology
keywords: human papillomavirus (HPV); management neck mass; oropharyngeal cancer; unknown primary