Classically, the risk factors associated with squamous cell carcinoma of the head and neck (CECC) have been the consumption of tobacco and alcohol, however, studies developed in the US and in northern European countries have detected a decrease in the incidence of carcinomas associated to tobacco and alcohol and an increase in the incidence of infection by Human Papilloma Virus (HPV). Thus, the incidence of squamous cell carcinomas of the oropharynx related to HPV would exceed 60% of the total in the countries studied.
Carcinomas related to Human Papilloma Virus (CECC HPV) are characterized by:
a) being frequently located in the oropharynx (tonsils, tongue base, soft palate, valleculas and palatoglossal folds)b) affect patients without a history of tobacco and alcohol use
c) predominate in the male sex
d) appear at an earlier age than usual for the rest of CECC HPV
e) associate with undifferentiated tumors
f) present special sensitivity to treatment with chemotherapy and radiotherapy.
As indicated in point f), these types of carcinomas have better survival rates, although CECC HPV + have also been associated with higher rates of metastasis.
The transmission of certain subtypes of HPV is sexual, which determines that some sexual practices and the high number of sexual partners are direct triggers of this type of tumors. That is why it is important to dedicate a part of the medical examination to ask about risky sexual relations, as well as to add in the sex education talks the risks of transmission of infections with oncogenic risk.
It should be noted that the vast majority of high-risk HPV infections do not cause malignant tumors, nor do they present symptoms of any kind, so in many cases the individual who is the source of transmission does not know their infection status.
Regarding its presence in the oral cavity, the prevalence of HPV was approximately three times more common in men than in women, as occurs in cancer of the oropharynx associated with HPV.
In Spain, the Department of Health finances systematic vaccinations for adolescents between 11 and 12 years old. However, recent studies show that the incidence of HPV-related tumors would justify vaccination of the entire population.