O crescente papel do papilomavírus humano no câncer de orofaringe — aspectos epidemiológicos, clínicos e estratégias de prevenção: uma revisão narrativa
DOI:
https://doi.org/10.5327/2237-4574-244Palavras-chave:
Papilomavírus humano, câncer de orofaringe, epidemiologia, prevenção, vacinaçãoResumo
O papilomavírus humano (HPV) tem se consolidado como um dos principais fatores etiológicos do câncer de orofaringe, especialmente em países de alta renda, onde tem progressivamente substituído fatores de risco tradicionais como tabagismo e consumo de álcool. Este artigo tem como objetivo revisar criticamente as evidências atuais sobre a epidemiologia, fisiopatologia, impacto clínico e estratégias de prevenção do câncer de orofaringe associado ao HPV. Observa-se um aumento global da incidência, com predominância entre homens, bem como a ausência de programas de rastreamento eficazes. Além disso, o impacto na qualidade de vida dos pacientes é significativo, mesmo após o tratamento. A vacinação contra o HPV surge como estratégia central de prevenção, com elevada eficácia contra os principais genótipos oncogênicos. Conclui-se que o câncer de orofaringe associado ao HPV representa um desafio crescente de saúde pública, exigindo políticas integradas de prevenção, diagnóstico precoce e educação em saúde.
Referências
zur Hausen H. Papillomaviruses in the causation of human cancers. Nat Rev Cancer. 2002;2(5):342-50. https://doi.org/10.1038/nrc798
Kombe AJK, Li B, Zahid A, Mengist HM, Bounda G-A, Zhou Y, et al. Epidemiology and burden of human papillomavirus and related diseases, molecular pathogenesis, and vaccine evaluation. Front Public Health. 2021;8:552028. https://doi.org/10.3389/fpubh.2020.552028
Ferreira CC. The relation between human papillomavirus (HPV) and oropharyngeal cancer: a review. PeerJ. 2023;11:e15568. https://doi.org/10.7717/peerj.15568
Joseph AW, D’Souza G. Epidemiology of human papillomavirus–related head and neck cancer. Otolaryngol Clin North Am. 2012;45(4):739-64. https://doi.org/10.1016/j.otc.2012.04.003
Elseragy A, Salo T. Rising incidence of oral tongue squamous cell carcinoma in young women: Emerging non-traditional etiologic factors and clinical implications: A structured narrative review. Cancer Epidemiol. 2026;103:103138. https://doi.org/10.1016/j.canep.2026.103138
Marur S, D’Souza G, Westra WH, Forastiere AA. HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol. 2010;11(8):781-9. https://doi.org/10.1016/s1470-2045(10)70017-6
Doorbar J. Molecular biology of HPV infection and cervical cancer. Clin Sci (Lond). 2006;110(5):525-41. https://doi.org/10.1042/cs20050369
Castellsagué X, Alemany L, Quer M, Halec G, Quirós B, Tous S, et al. HPV in Head and Neck Cancer Study Group. HPV involvement in head and neck cancers: comprehensive assessment of biomarkers in 3680 patients. J Natl Cancer Inst. 2016;108(6):djv403. https://doi.org/10.1093/jnci/djv403
Sturgis EM, Cinciripini PM. Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer. 2007;110(7):1429-35. https://doi.org/10.1002/cncr.22963
Zumsteg ZS, Luu M, Rosenberg PS, Elrod JK, Bray F, Vaccarella S, et al. Global epidemiologic patterns of oropharyngeal cancer incidence trends. J Natl Cancer Inst. 2023;115(12):1544-54. https://doi.org/10.1093/jnci/djad169
Heck JE, Berthiller J, Vaccarella S, Winn DM, Smith EM, Shan’gina O, et al. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol. 2010;39(1):166-81. https://doi.org/10.1093/ije/dyp350
Serrano B, Brotons M, Bosch FX, Bruni L. Epidemiology and burden of HPV-related disease. Best Pract Res Clin Obstet Gynaecol. 2018;47:14-26. https://doi.org/10.1016/j.bpobgyn.2017.08.006
Coker KL, Morgan EL. High-risk HPV in men: a hidden threat to public health? Rev Med Virol. 2026;36(2):e70115. https://doi.org/10.1002/rmv.70115
Landy R, Haber G, Graubard BI, Campos NG, Sy S, Kim JJ, et al. Upper age limits for US male human papillomavirus vaccination for oropharyngeal cancer prevention: a microsimulation-based modeling study. J Natl Cancer Inst. 2023;115(4):429-36. https://doi.org/10.1093/jnci/djad009
Maglennon GA, Doorbar J. The biology of papillomavirus latency. Open Virol J. 2012;6:190-7. https://doi.org/10.2174/1874357901206010190
Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, Leemans CR, Aaronson NK, Slotman BJ. Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol. 2008;26(22):3770-6. https://doi.org/10.1200/JCO.2007.14.6647
de Martel C, Georges D, Bray F, Ferlay J, Clifford GM. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. Lancet Glob Health. 2020;8(2):e180-90. https://doi.org/10.1016/S2214-109X(19)30488-7
FUTURE II Study Group. Quadrivalent HPV vaccine. N Engl J Med. 2007;356(19):1915-27. https://doi.org/10.1056/nejmoa061741
Huh WK, Joura EA, Giuliano AR, Iversen OE, Andrade RP, Ault KA, et al. Nine-valent HPV vaccine efficacy. Lancet. 2017;390(10108):2143-59. https://doi.org/10.1016/s0140-6736(17)31821-4
