An Integrated Approach for Preventing Oral Cavity and Oropharyngeal Cancers: Two Etiologies with Distinct and Shared Mechanisms of Carcinogenesis

Cancer Prev Res (Phila). 2020 Aug;13(8):649-660. doi: 10.1158/1940-6207.CAPR-20-0096. Epub 2020 May 20.

Abstract

Head and neck squamous cell carcinoma (HNSCC) was the 7th most common malignancy worldwide in 2018 and despite therapeutic advances, the overall survival rate for oral squamous cell carcinoma (OSCC; ∼50%) has remained unchanged for decades. The most common types are OSCC and oropharyngeal squamous cell carcinoma (OPSCC, survival rate ∼85%). Tobacco smoking is a major risk factor of HNSCC. In the developed world, the incidence of OSCC is declining as a result of tobacco cessation programs. However, OPSCC, which is also linked to human papillomavirus (HPV) infection, is on the rise and now ranks as the most common HPV-related cancer. The current state of knowledge indicates that HPV-associated disease differs substantially from other types of HNSCC and distinct biological differences between HPV-positive and HPV-negative HNSCC have been identified. Although risk factors have been extensively discussed in the literature, there are multiple clinically relevant questions that remain unanswered and even unexplored. Moreover, existing approaches (e.g., tobacco cessation, vaccination, and chemoprevention) to manage and control this disease remain a challenge. Thus, in this review, we discuss potential future basic research that can assist in a better understanding of disease pathogenesis which may lead to novel and more effective preventive strategies for OSCC and OPSCC.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alphapapillomavirus / immunology
  • Animals
  • Disease Models, Animal
  • Humans
  • Incidence
  • Mass Vaccination / organization & administration
  • Mice
  • Microbiota / immunology
  • Mouth / microbiology
  • Mouth / pathology
  • Mouth Neoplasms / epidemiology
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / prevention & control*
  • Mouth Neoplasms / virology
  • Oropharyngeal Neoplasms / epidemiology
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / prevention & control*
  • Oropharyngeal Neoplasms / virology
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Infections / virology
  • Papillomavirus Vaccines / administration & dosage
  • Risk Factors
  • Squamous Cell Carcinoma of Head and Neck / epidemiology
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / prevention & control*
  • Squamous Cell Carcinoma of Head and Neck / virology
  • Tobacco Smoking / epidemiology
  • Tobacco Use Cessation

Substances

  • Papillomavirus Vaccines