Mouth and Throat Cancer Rates Increasing

The journal Otolaryngology-Head and Neck Surgery has noted an increase in the incidence of oropharyngeal squamous cell carcinoma in patients younger than 45 years over the time period from 1973 to 2009.  In addition, there was an increase, from 28% to 43%, in the proportion of grade III/IV tumors.  Treatment for this type of cancer involves surgery, often in combination with radiation therapy.  As with any cancer, early detection is most important.  For this type of tumor, the five year survival rate is 54%.  The rising incidence is thought to be related to transmission of the human papilloma virus (HPV) and changes in sexual practices.  This is added evidence is support of vaccinating both boys and girls to prevent disease.

Source:  HealthDay News


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

President's Panel: Increase HPV Vaccination

Chemotherapy Advisor, via Health Day News, superior sources of current cancer and drug information, reports that the President's Cancer Panel states that too few American girls and boys are getting vaccinated against human papillomavirus (HPV).

Current recommendations from the CDC are detailed at www.chemotherapyadvisor.com.  The Panel states that in creasing HPV vaccination rates to 80% would prevent 53,000 future cervical cancer cases among girls who are currently aged 12 years and younger, and that it would prevent thousands of cases of other HPV-related cancers in both females and males.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV Infections in the Mouth

HPV can infect oral tissues.  A subgroup of oral cancer clearly is associated with HPV.  Oral HPV is transmitted sexually but also can be transmitted from mouth to mouth and vertically from an infected mother during delivery.  A detailed description of the mechanism by which an HPV lesion develops into oral cancer, with pictures, is found in JADA August 2011, 142(8), pp905, at www.jada.ada.org

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV Oral Cancer on the Rise

Human papillomavirus (HPV) is responsible for more than 5% of all cancers, including all cervical cancers.  Presently, an estimated 63% of oropharyngeal cancers are caused by HPV, and tha percentage is rising.  At current rates, oropharyngeal cancer will become the leading HPV-related cancer in the United States by the year 2020, surpassing the yearly number of cervical cancers.  An estimated 7,400 new cases of HPV-related oropharyngeal cancers are diagnosed annually.  These cases are highest among adults in their late 20's and late 50's.  Men outnumber women 4:1.  These cancers are most commonly found on the tonsils.  Others are found at the base of the tongue.  In these areas, diagnosis is usually at advanced stages (75% stage III/IV), with lymph node involvement.

While the prevalence of HPV infection is about 7% in the general population, it can be as high as 20% for those with more that 20 lifetime sex partners (oral, anal, and/or vaginal) or who smoke more than 20 cigarettes daily.


Source: www.chemotherapyadvisor.com


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV Vaccinations

Because HPV infections are very common and often asymptomatic, because there is a direct relationship between HPV infection and increased prevalence of cervical, anogenital and oropharyngeal cancers, because diseases often develop many years after infection, and because there is an available vaccine, the FDA recommends vaccination of boys and girls at the age of 11 or 12 years.

The vaccines currently available prevent infection from the HPV strains that cause most of the cervical, vaginal and vulvar cancers in women.  Vaccinating boys curtails HPV transmission.  Both males and females may develop cancers of the oropharynx and tonsils.  The FDA recommends that the vaccines be given up to the age of 26.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Oral Cancer: Who, When, Where

In the US there are an estimated 36,450 new cases of oral cancer diagnosed each year, 25,420 in men and 11,120 in women.  Nearly 7,880 people die of cancer of the oral cavity and pharynx each year.  The average age for diagnosis is 62 years and 1.02% of people born today will be diagnosed with it during their lifetime.  Approximately 90% of oral cancer is on the surface and called squamous cell carcinoma.  Traditional risk factors are tobacco and alcohol.  When someone smokes and drinks, their risk is increased 37-fold.  Higher risk sites include the tongue and floor of the mouth.  Cancer of gum tissues accounts for about 10% of all oral cancers.  Although the average age for diagnosis is 62 years, a rapidly growing number of younger patients without traditional risk factors are being diagnosed with HPV - related tumors of the tonsils and base of the tongue.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV Infections in the Mouth

HPV can infect oral tissues.  A subgroup of oral cancer clearly is associated with HPV.  Oral HPV is transmitted sexually but also can be transmitted from mouth to mouth and vertically from an infected mother during delivery.  A detailed description of the mechanism by which an HPV lesion develops into oral cancer, with pictures, is found in JADA August 2011, 142(8), pp905, at www.jada.ada.org

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV and Cancer of the Base of the Tongue,Tonsils and Oropharynx

Oral and pharyngeal squamous cell carcinomas have been associated with alcohol and tobacco use.  Recent studies suggest cancers of the back (base) of the tongue and tonsils are associated with high-risk HPV types.  While there has been a decrease in oral cavity cancer rates due to a decrease in smoking, there has been an increase in HPV associated cancers in the back of the throat.  Transmission by skin-to-skin contact during oral sex and open-mouthed kissing is the mode of infection. 

Details in:  JADA, 2011, 142 (8), pp. 915 with pictures at www.jada.ada.org

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV and Oral Cancer

HPV can infect oral tissues.  A subgroup of oral cancer clearly is associated with HPV.  Oral HPV is transmitted sexually but also can be transmitted from mouth to mouth and vertically from an infected mother during delivery.  A detailed description of the mechanism by which an HPV lesion develops into oral cancer, with pictures, is found in JADA August 2011, 142(8), pp905, at www.jada.ada.org

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

Causes of Oral Cancers Changing

Oral and pharyngeal squamous cell carcinomas have been associated with alcohol and tobacco use.  Recent studies suggest cancers of the back (base) of the tongue and tonsils are associated with high-risk HPV types.  While there has been a decrease in oral cavity cancer rates due to a decrease in smoking, there has been an increase in HPV associated cancers in the back of the throat.  Transmission by skin-to-skin contact during oral sex and open-mouthed kissing is the mode of infection.

It should be noted that oral cancers due to alcohol and tobacco are steadily declining but those due to HPV are increasing dramatically. 

Details at www.jada.ada.org

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV and Oropharyngeal Cancer: Risk Factors

Leslie Burgess, writing for Chemotherapy Advisor, continued her thorough and well researched article on the growing dilemma of HPV-Associated Oropharyngeal Cancer. She states: "An estimated 7,400 new cases are diagnosed annually in the U.S. Prevalence of oral infection is highest among adults in their late 20's and late 50's, and the disease is more common in men than women (almost 4:1) and in non-Hispanic populations. The presence of oral HPV infection is about 7% of the general population, but can be as high as 20% among those with a high number (20 or more) of lifetime sex (oral, anal, and/or vaginal) partners, early age (<17 years) at first intercourse and irregular or no condom use. Persistence of HPV infection increases cancer risk.

For more detail:  www.chemotherapyadvisor.com

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

HPV and Oropharyngeal Cancer: Increasing Rates

In a superb article in Chemotherapy Advisor, Leslie Burgess illustrates the increasing concern regarding HPV virus as the cause of more than 5% of all cancers, including all cervical cancers.  In addition, at current rates, by the year 2020 in the United States, oropharyngeal cancer will become the leading HPV associated cancer, surpassing the annual number of cervical cancers.

The incidence rates and types of HPV cancers are tabulated at www.chemothrapyadvisor.com

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309