Oral Cancer and Oral HPV

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Oral cancer has become the sixth most common form of cancer in the United States.  In 2010, the connection was made between oral HPV (human papillomavirus) and oral cancer resulting in the realization that not all cancers are caused by tobacco and alcohol.  Oral HPV infection, and especially infection with HPV-16, has been acknowledged as a risk factor for developing oropharyngeal cancer, particularly oropharyngeal squamous cell carcinoma (OSCC) by the International Agency for Research Against Cancer.  A recent published study in the Journal of Emerging Infectious Diseases suggests that there is a slow epidemic of HPV infection-induced oral cancers, notably OSCC.

The incidence of these oral cancers, or number of new cases diagnosed, has increased significantly among persons between ages 20 and 39 in the U.S.  Persons with prior HPV infections are 32 times more likely to develop oral cancers at the base of the tongue and tonsils than those who do not.  This is about 10 times greater than the risk associated with chronic alcohol or tobacco use.

When oral cancer is found early, treatment can be successful 82% of the time.  Whatever the cause, oral cancer at its earliest stages is difficult to discern from healthy tissue.  By the time the lesion is visually apparent or symptomatic, it is likely to require surgical removal.  Because early detection is a key to survival, an annual screening exam by your dentist using a tissue fluorescence device in conjunction with a routine head and neck examination, can help to find abnormalities that could lead to cancer.  We use  a tissue fluorescence device in our office called VisiLite Plus with TBlue that shines light of a specific wave length onto the oral mucosa.  This light interacts with dysplastic tissue differently than normal tissue, and therefore fluoresces differently than normal tissue.  Depending on the individual risk factors of the patient, the suspect lesion can be monitored over time for changes or symptoms, or a biopsy can be taken and tested for cancer.

Today, there are also tests available to screen for the various types and levels of oral HPV infection, especially HPV-16 and HPV-18, which are the variants most commonly linked to oral cancer.

Ask your dentist about having an oral cancer exam done on a yearly basis.  When oral cancer is found early, treatment is less invasive and outcomes far better.