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Evidence for a causal association for HPV in head and neck cancers

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Abstract

Current data have now attributed a viral etiology and causality of Human papillomavirus (HPV). Epidemiological analysis of the last decade demonstrates a rapid increase of HPV-associated HNSCC. Genomic detection of HPV DNA in the nuclei of certain oro-pharyngeal cancer cells gives strong evidence of a viral etiology in HNSCC. Non-smokers, non-drinkers, and a sexual debut at a younger age and other sexual risk factors have an increased risk of HPV-positive oropharyngeal cancer. Sexual transmission is considered to play a causal role. In contrast to HPV-negative HNSCC most studies reveal a favorable prognosis for HPV-positive tumors. There is evidence of alterations in the p53 pathway through expression of E6 oncogene with subsequent induction of tumor cell proliferation. Synergies between viral oncogenes and other carcinogens are hypothesized. HPV alone appears to be insufficient as the sole cause of HNSCC; this may explain the long latency period between HPV infection and cancer development. There is now sufficient evidence for a causal role for HPV in HNSCC. As in cervical cancer, HPV requires oncogenes and co-factors for tumor development. Thus, inhibition or loss of such co-factors may lead to tumor regression. The vast amounts of epidemiological, molecular pathological and in vitro experimental data are consistent with the hypothesis that HPV does indeed have a causal role. We await final validation from animal experimentation in which regression of HPV-positive tumors will follow from loss or inhibition of E6 and E7.

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Acknowledgments

This work was supported by grants from the British Skin Foundation and Cancer Research UK to PKCG and Zinkann Stiftung, Germany to HS.

Conflict of interest

PKCG and MAS act as consultants to Sanofi Pasteur-MSD, Lyon, France and are in receipt of an unrestricted educational grant. HS acted as a consultant to Sanofi Pasteur-MSD, Lyon, France. MAS also acts as consultant to Merck Research Laboratories, Westpoint, USA, and GSK Biologicals, Rixensart, Belgium.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Academic Teaching Hospital of University of Münster, Teutoburger Str. 50, 33604, Bielefeld, Germany

    H. H. Sudhoff & H. P. Schwarze

  2. Department of Pathology, University of Cambridge, Cambridge, UK

    D. Winder, M. Stanley & P. K. C. Goon

  3. Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

    L. Steinstraesser

  4. Department of Hematology and Oncology, Academic Teaching Hospital of University of Münster, Bielefeld, Germany

    Martin Görner

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  1. H. H. Sudhoff
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Correspondence to H. H. Sudhoff.

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Sudhoff, H.H., Schwarze, H.P., Winder, D. et al. Evidence for a causal association for HPV in head and neck cancers. Eur Arch Otorhinolaryngol 268, 1541–1547 (2011). https://doi.org/10.1007/s00405-011-1714-8

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