HPV Infection and Racial Disparities in Head and Neck Cancer
Posted: Monday, February 4, 2019
Coexisting human papillomavirus (HPV) infection in patients with head and neck squamous cell cancer may affect disease prognosis and therapeutic responses. According to a review by Sanjib Chaudhary, PhD, and colleagues, of the University of Nebraska, Omaha, published in the Journal of the National Cancer Institute, HPV co-infection may partially account for the racial disparities observed in outcomes for patients with head and neck cancer (African American patients have worse prognosis than white patients). In addition, the authors cited HPV co-infection as possibly contributing to better outcomes. (In the United States, the incidence of HPV-induced head and neck cancer is higher in white than in African American individuals.)
In their review, the authors discussed factors that likely contribute to disparate prognoses; in addition to socioeconomic factors and access to timely diagnosis and treatment, they highlighted the variability of locoregional origin of tumors, somatic mutations, and coexisting HPV infections.
HPV may affect head and neck cancer outcome in myriad ways. It is an independent risk factor for oropharyngeal cancers, reflected in a relative paucity of oropharyngeal cancers in African American individuals. Furthermore, patients with HPV had lower rates of mutation in genes driving head and neck tumorigenesis. Moreover, patients with HPV seemed to be less tolerant of radiation therapy, with a lower rate of locoregional occurrence than in those who had HPV-negative tumors. Finally, tumor metabolism and the tumor microenvironment were altered in patients with HPV.
“Prodigious research is required to stratify [African American] and white patient populations on the basis of their HPV status, somatic mutational load, and immune-metabolic characteristics,” concluded the authors.
Disclosure: The study authors’ disclosure information may be found at academic.oup.com.