title: The New Face of Head and Neck Cancer: The HPV Epidemic.
abstract: There has been a significant increase in the incidence of human papillomavirus (HPV)-mediated oropharyngeal cancer in the United States. This entity is most commonly diagnosed in nonsmoking middle-aged white males. The majority of the patients present with asymptomatic, persistent neck masses despite antibiotic therapy. An awareness of this condition and a high degree of suspicion is necessary for timely diagnosis. HPV-mediated oropharyngeal squamous cell carcinomas (HPV-OPSCCs) are unique biologically and clinically, and affected patients enjoy better outcomes with existing standard therapies than do patients with OPSCC mediated by tobacco exposure. The p16 protein is usually overexpressed in HPV-OPSCC, and its detection on immunohistochemistry is a reliable surrogate marker for this disease. In this review, we discuss current paradigms in the diagnosis and management of HPV-OPSCC, and we emphasize pertinent research questions to investigate going forward, including whether to deintensify treatment in these patients.
authors.forename: Aaron
authors.initials: A
authors.lastname: Lewis
authors.forename: Robert
authors.initials: R
authors.lastname: Kang
authors.forename: Alexandra
authors.initials: A
authors.lastname: Levine
authors.forename: Ellie
authors.initials: E
authors.lastname: Maghami
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D002472:Cell Transformation, Viral; D004279:DNA, Viral / Q000235:genetics; D058872:Epidemics; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D004279:DNA, Viral