title: The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer.
abstract: The incidence of oropharyngeal cancer (OPC) is significantly increasing in the United States. Given that these epidemiologic trends are driven by human papillomavirus (HPV), the potential impact of prophylactic HPV vaccines on the prevention of OPC is of interest. The primary evidence supporting the approval of current prophylactic HPV vaccines is from large phase 3 clinical trials focused on the prevention of genital disease (cervical and anal cancer, as well as genital warts). These trials reported vaccine efficacy rates of 89% to 98% for the prevention of both premalignant lesions and persistent genital infections. However, these trials were designed before the etiologic relationship between HPV and OPC was established. There are differences in the epidemiology of oral and genital HPV infection, such as differences in age and sex distributions, which suggest that the vaccine efficacy observed in genital cancers may not be directly translatable to the cancers of the oropharynx. Evaluation of vaccine efficacy is challenging in the oropharynx because no premalignant lesion analogous to cervical intraepithelial neoplasia in cervical cancer has yet been identified. To truly investigate the efficacy of these vaccines in the oropharynx, additional clinical trials with feasible endpoints are needed. Cancer 2016;122:2313-2323. © 2016 American Cancer Society.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Theresa
authors.initials: T
authors.lastname: Guo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: David W
authors.initials: DW
authors.lastname: Eisele
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.|Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Carole
authors.initials: C
authors.lastname: Fakhry
mesh_terms: D019496:Cancer Vaccines / Q000276:immunology*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D027383:Papillomaviridae / Q000276:immunology*; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000276:immunology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014611:Vaccination
chemical_list: D019496:Cancer Vaccines; D053918:Papillomavirus Vaccines
keywords: cancer vaccines; human papillomavirus (HPV); human papillomavirus vaccines; oropharyngeal neoplasms; squamous cell carcinoma of the head and neck