Papillomaviruses and head and neck cancer

HNC is the sixth most common malignancy reported worldwide and one with a high case fatality rate, with an estimated global burden of approximately 550 000 incident cases and 300 000 deaths per year. Alcohol consumption, smoking, poor oral hygiene and genetic features are key risk factors for HNC development.

Recently, it has become clear that 25 % of the worldwide cases are associated with a certain type of HPV, HPV 16. Among the different types of HNC, oropharyngeal carcinomas are the most frequently HPV 16–associated ones. The Indian sub-continent has the highest HNC incidence in the world, and HNC accounts for approximately 30–40 % of all cancer types in India. At present, little is known about general epidemiology and risk factors of oral HPV infection.

The EU-funded HPV-AHEAD project aims to address HNC aetiology and epidemiology with a focus on the role of HPV. Epidemiological studies will be conducted to establish the proportion and type of distribution of HPV in different types of HNC in European and Indian regions. Consortium members plan to further investigate whether HPV positivity confers a better prognosis and survival, and to search for new markers for oral HPV infection.

In the first 18 months of the study, HPV-AHEAD has established and fully validated many key protocols, including collection of centralised data and specimens, processing of specimens in different laboratories and laboratory assays. Researchers have so far collected approximately 2 000 HNC specimens (20 % of the total planned). To facilitate the processing of the specimens in India, two Luminex-based platforms to detect HPV DNA and human antibodies against the viral proteins have been transferred from European laboratories to an Indian partner.

Results of the programme to date have been presented at a meeting in India and in four printed publications.

It is expected that the findings obtained in the HPV-AHEAD study will provide accurate figures on the prevalence of HPV-positive HNC in Europe and India. They will also provide important insights for the screening, diagnosis, treatment and prophylaxis of HPV-associated HNC.