hpv gardiasil, hpv vaccine, hpv vaccination
Charles Rex Arbogast/AP
Dr. Donald Brown inoculates 14-year-old Kelly Kent with Gardiasil, a new vaccine for the
human papillomavirus, in his Chicago office, Aug. 28, 2006.

Study Links HPV to Head and Neck Cancer Survival, Shedding Light on Racial Divide

August 04, 2009 10:45 AM
by Jill Marcellus
A new study connects HPV to better prognoses for head and neck cancer, possibly explaining why African Americans fare worse against the disease.

A Positive Prognosis for HPV-Positive Cancer Patients

The sexually transmitted human papillomavirus (HPV) has long been associated with certain kinds of cancer. Now, researchers have found that head and neck cancer patients who carry the infection are more likely to survive than HPV-negative patients, according to a study by the University of Maryland Marlene and Stewart Greenebaum Cancer Center.

Only a quarter of cases involving this head and neck cancer, squamous cell carcinoma, are tied to HPV, but those patients’ survival rate was a high 85 percent at five years, according to Dr. Kevin Cullen, director of the cancer center and senior author of the study. By comparison, patients with HPV-negative tumors had only a 35 percent survival rate.

Dr. Cullen emphasized that HPV does not somehow protect cancer patients, but rather that the virus causes more treatable cancers than those that arise from tobacco or alcohol abuse, ABC News reported. He called this a “paradox,” explaining that “HPV may cause some of these cancers, but HPV-positive cancers behave biologically very well—they are very responsive to chemotherapy and radiation.”

This discovery is “practice-changing” and will affect the prognosis and treatment of future head and neck cancer patients, according to Dr. Scott Lippman, editor-in-chief of the journal Cancer Prevention Research, which published the article. Already, Dr. Cullen noted, doctors are adding HPV-testing to their routine.

Dr. Lippman heralded the study as “the most important development in head and neck cancer that I’ve seen in the past 30 years.”

Racial Implications

Researchers believe that the study explains the notoriously poor survival rate for African-American patients, a mystery that has long surrounded squamous cell carcinoma. Experts have previously tried to explain the racial survival gap through differences in treatment quality or access, The New York Times reported, but the HPV link provides a biological cause.

African Americans are far less likely to have oral HPV, and thus, it appears, less likely to have the more treatable variety of head and neck cancer. Indeed, only 4 percent of black cancer patients in the study were HPV-positive, as opposed to 34 percent of white patients.

Although researchers offered a number of possible explanations for this racial divide, nobody is entirely certain why African-American patients have such a low rate of oral HPV. Dr. Otis Brawley of the American Cancer Society looks to differing sexual practices among white and black teenagers, explaining that white teenagers are more likely than African Americans to engage in oral sex before genital sex. Since, he claims, contracting HPV genitally first would likely prevent a later oral infection, this difference “makes a lot of sense in terms of causation” for oral HPV, according to ABC News.

Dr. Cullen accepts this possibility, but insists that other factors “that now we just don’t understand” are probably involved as well.

Related Topic: HPV Vaccine

Responsible for almost 100 percent of cervical cancer cases, HPV has earned considerable attention in relation to women’s health. The drug company Merck released the HPV vaccine Gardasil in 2006, which it targeted to adolescent girls as a preventative measure for cervical cancer. Despite some concerns about the vaccine, the U.S. Centers for Disease Control announced that a quarter of girls aged 13 to 17 had received the vaccine as of October last year.

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