Head & Neck Surgery
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What is Oropharyngeal Cancer?
The oropharynx is the part of the throat that lies just behind the oral cavity and in the back of the mouth. The tonsil, tongue-base and soft palate are the most well-known areas of this region of the throat, which can only be visualized using special endoscopes or mirrors.
In 2014, an estimated 44,000 patients were estimated to be diagnosed with oral and pharyngeal cancer. More than 90% of oropharyngeal cancers are squamous cell carcinomas—so called because the tumors arise from the thin, flat “squamous” cells that cover the lining of the throat.
In the past, tumors arising in the oropharynx were uncommon and associated with heavy tobacco use. Over the past decade, there has been a dramatic change in the epidemiology of oropharyngeal cancer (OPC). A striking association has been made between oropharyngeal cancer and prior infection with the human papillomavirus (HPV).
Using the Surveillance, Epidemiology, and End Results (SEER) repository, investigators have shown that from 1988 to 2004, the incidence of HPV-positive oropharyngeal cancers increased by 225 percent. (doi = 10.1200/JCO.2011.36.4596)
Patients with OPC related to HPV tend to present earlier in life as compared to those with tobacco-associated OPC. The primary tumor is often difficult to see, hidden within the folds of the throat (tongue-base and tonsil.)
As a result, OPC cases typically are not diagnosed until the tumor metastasizes to the neck.
Numerous questions—about how to identify this disease earlier, how to prevent it, and which individuals are at greatest risk—continue to challenge researchers in the field. Yet, one thing is clear: multidisciplinary teams must transform therapy to keep pace with this “new” disease. Given these sweeping changes in the epidemiology of head and neck cancer, and in particular, the precipitous rise in HPV associated OPC, improvements in screening, prevention, and treatment must be made quickly.