HPV Infection Linked to Survival in Some Head and Neck Cancers

Aug. 1, 2009— -- In what some doctors are calling the most important development in head and neck cancer in decades, researchers have discovered that head and neck cancers caused by the human papillomavirus, otherwise known as HPV, are more survivable than other forms of head and neck cancer.

Having an HPV-positive tumor was associated with significantly longer overall survival in two different studies, according to Dr. Kevin Cullen, director of the Greenebaum Cancer Center of the University of Maryland in Baltimore, and colleagues.

The finding also helps to explain why black Americans with throat cancer, otherwise known as oropharyngeal cancer do worse than whites, the researchers said in the September issue of the journal Cancer Prevention Research.

At a press conference Wednesday, Cullen and other experts told reporters that the finding should change practice. "We are now testing for HPV, which we weren't doing even a few months ago," Cullen said.

HPV testing for patients with throat cancer has implications for both prognosis and treatment, he said.

Overall, Cullen said, blacks are known to have worse outcomes for a type of cancer known as squamous cell carcinoma of the head and neck, although the reasons for the differences have not been entirely clear.

"This is the first clue that it may be biologic rather than related to issues of access, insurance or provider attitudes," he said.

The "paradox," Cullen told reporters, is that "HPV may cause some of these cancers, but HPV-positive cancers behave biologically very well -- they are very responsive to chemotherapy and radiation."

He said the virus is not protective, but instead gives rise to cancers that are more vulnerable to treatment with chemotherapy and radiation than are those caused by tobacco and alcohol use.