Researchers at the Johns Hopkins School of Medicine and School of Hygiene and Public Health have found the sexually transmitted human papillomavirus (HPV) to be a likely cause of certain cancers of the head and neck and also an indicator of improved survival. Their findings are reported in the May 3, 2000, issue of the Journal of the National Cancer Institute.

The investigators studied tumors of 253 patients, ages 17 to 91, with newly diagnosed or recurring squamous cell head and neck cancer. HPV was detected in 62, or 25 percent, of the tumors and, of the HPV-positive tumors, 90 percent contained a high-risk, tumor-promoting form of the virus known as HPV-16. Somewhat unexpectedly, perhaps, those with HPV-positive tumors were 60 percent less likely to die from their head and neck cancer than those with HPV-negative tumors, according to the researchers. The data provide strong evidence that HPVs may be the cause of a defined subset of head and neck cancers, particularly those of the oropharynx (tonsils and throat), and this association with HPV infection also is linked to a markedly improved prognosis. While they currently cannot explain the improved survival, follow-up of participants revealed that the average survival of patients with HPV-positive tumors was 91 months or more but 76 months among patients with HPV-negative tumors. Other factors contributing to poor prognosis included advanced disease, age, and heavy alcohol consumption.

"These data suggest that HPV-positive head and neck cancers may comprise a distinct molecular, clinical, and pathologic disease very different from other types of the disease," says the Oncology Center's Maura L. Gillison, M.D., lead author of the study.

Squamous cell head and neck cancer is a disease largely attributable to environmental exposures-primarily tobacco and alcohol use. Fifteen to 20 percent of these cancers, however, occur in non-smokers and non-drinkers. "In this study, those with HPV-po
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Contact: Vanessa Wasta
wastava@jhmi.edu
410-955-1287
Johns Hopkins Medical Institutions
2-May-2000