Researchers Find that Head and Neck Cancers May Be Different Diseases

Different risk factors for head and neck cancer have been identified by researchers at Johns Hopkins Kimmel Cancer Center, raising the possibility that they are different forms of these diseases.

Head and neck tumors caused by the human papillomavirus (HPV) were generally associated with sexual behaviors and smoking marijuana, rather than tobacco and alcohol. It was also found that people with the viral-linked cancer were mostly white, younger, married, and college-educated with income of $50,000 or more. Those not attributable to HPV were associated with tobacco, alcohol and poor oral hygiene, most generally listed as the causes of head and neck cancer. The findings are to be published in the March 12 issue of the Journal of the National Cancer Institute.

"Our results indicate that HPV-positive and HPV-negative head and neck cancers have different risk-factor profiles and should be considered two distinct diseases," says Maura L. Gillison, M.D., Ph.D., an associate professor of oncology and epidemiology at Hopkins. "They just happen to occur in the same place."

HPV infection has been seen in up to 72% of patients, and is associated with the development of some neck and head cancers, mostly in the upper throat and back of the tongue. Gillison noted that the incidence of HPV-linked cancer has nearly doubled over the past 30 years, and that head and neck cancer patients with HPV-positive tumors are mlore responsive to treatment and survive longer than HPV-negative patients.

According to Gillison, the American Joint Committee on Cancer is now considering incorporating HPV status in its guidelines for determining clinical stages of head and neck cancer.

For this study, 240 patients at the Johns Hopkins Hospital with head and neck squamous cell carcinomas were studied between 2000 and 2006, to identify HPV-positive or negative tumors. All study participants completed a computerized interview that asked questions about their risk factors.

Source: Journal of the National Cancer Institute, March 12, 2008

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