HPV-positive oropharyngeal cancer

HPV-positive oropharyngeal cancer is a squamous cell cancer of the throat caused by human papillomavirus type 16, acquired mainly through oral-genital contact with a person who has a genital HPV infection. Once attributed to tobacco and alcohol, most oropharyngeal cancers are now linked to the virus, and it is regarded as a disease separate from HPV-negative oropharyngeal cancer. Patients tend to be younger, less often smokers and to have smaller tumours with more neck lymph node involvement, and its incidence is rising, especially in young men in developed countries. It may appear as a painless mouth abnormality, local pain, difficulty speaking or swallowing, or a neck swelling. Diagnosis commonly relies on detecting the p16 protein. Treatment ranges from minimally invasive surgery to radiotherapy and chemotherapy, and HPV-positive disease responds better and has a better outcome. Vaccination against HPV types 16 and 18 is being used to reduce incidence.