Trends in head and neck cancer incidence in Denmark, 1978–2007: Focus on human papillomavirus associated sites

Abstract

The aim of our study was to assess the overall trends in the incidence of head-and-neck cancer (HNC) among Danish men and women in 1978-2007, to describe the distribution and incidences of HNCs at different anatomical sites, and to determine whether the incidence of human papillomavirus (HPV)-associated cancers is increasing. Data were extracted from the nationwide Cancer Registry database. To assess the possible impact of HPV infection, the sites of squamous cell carcinomas were categorized as HPV-associated, potentially HPV-associated or HPV-unrelated. In total, 26,474 incident cases were identified and the overall incidence increased throughout the period. Significantly increasing incidence rates were notably seen for tumors in the oral cavity (2.2% per year), tonsils (4.8% per year), oropharynx (3.5% per year) and hypopharynx (4.4% per year). A significantly decreasing incidence of lip cancer was observed among men (-5.0% per year). Cancers at HPV-associated sites (n 5 3650) showed strongly increasing incidence rates, primarily in individuals < 60 years. In contrast, HNCs at sites not related to HPV infection showed a significant decrease (in men) or virtually no change in incidence (in women). Our results suggest a marked impact of HPV infection on the epidemiology of HNCs in Denmark. HPV16 is the type most often found in HNCs; thus, the recent introduction of vaccination against HPV may in the future prevent HPV-associated cancers of the head and neck.

Knowledge of Brazilian Dentists about Oral Cancer

“…Suggested that hypothesis based on fact that 10 to 20% of patients with oral cancer no related to use of tobacco and alcohol [11]. In literature, among oncogenic virus, Human Papilomavirus (HPV) is the most frequent in individuals with head and neck cancer [8,26,30]. In our study, no interviewed cited viruses infections as risk factor for oral cancer.…”

“…Although tobacco and alcohol are considered main risk factors for the development oral cancer, the participation of infectious agents such as virus, has also been associated with this etiopathogenesis [26][27][28][29][30]. Suggested that hypothesis based on fact that 10 to 20% of patients with oral cancer no related to use of tobacco and alcohol [11].…”

“…Some factors may explain the reduced number of oral cancer cases that are diagnostic in early stage such as absence of symptoms, lower frequency of exams for diagnosis, lower level of knowledge of the population and health professionals about signs, symptoms and risk factors of oral cancer and absence of educational programs aimed at reducing risk factors [27][28][29][30].…”

Trends in all-cause five-year mortality after head and neck cancers diagnosed over a period of 33 years. Focus on estimated degree of association with human papillomavirus

“…The known risk factors for HNC include tobacco smoking, alcohol drinking, and certain viruses, such as the Epstein-Barr virus and human papillomavirus (HPV) [1,2]. Increase in exposure to HPV over the past few decades have been shown to influence the incidence of certain HNSCCs with significant increases of some HNSCCs, such as those of the oropharynx, especially the tonsil and base of the tongue [3][4][5]. In Denmark, an overall increase in the incidence of HNSCC has been reported, due primarily to an increased incidence of cancers at sites reported to be associated with HPV [3].…”

“…Increase in exposure to HPV over the past few decades have been shown to influence the incidence of certain HNSCCs with significant increases of some HNSCCs, such as those of the oropharynx, especially the tonsil and base of the tongue [3][4][5]. In Denmark, an overall increase in the incidence of HNSCC has been reported, due primarily to an increased incidence of cancers at sites reported to be associated with HPV [3]. In contrast, the incidence of some other HNCs has decreased, potentially due to a decrease in smoking [6,7].…”