The emerging role of human papillomavirus in oropharyngeal cancer — epidemiology, clinical implications, and prevention strategies: a narrative review
DOI:
https://doi.org/10.5327/2237-4574-244Keywords:
Human papillomavirus viruses, oropharyngeal cancer, epidemiology, prevention, vaccinationAbstract
Human papillomavirus (HPV) has emerged as one of the main etiological factors of oropharyngeal cancer, especially in high-income countries, where it is progressively replacing traditional risk factors such as tobacco use and alcohol consumption. This article aims to critically review current evidence on the epidemiology, pathophysiology, clinical impact, and prevention strategies of HPV-associated oropharyngeal cancer. A global increase in incidence is observed, with a predominance among men, as well as a lack of effective screening programs. In addition, the impact on patients’ quality of life is significant, even after treatment. HPV vaccination has emerged as a central prevention strategy, with high efficacy against the main oncogenic genotypes. It is concluded that HPV-associated oropharyngeal cancer represents a growing public health challenge, requiring integrated policies for prevention, early diagnosis, and health education.
References
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