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Health & Fitness

Study Reveals Increase in Oral, Head and Neck Cancer, Highlights Need for Screening

A first-of-its-kind study shows that sore throat and neck mass in people with HPV are the most common initial symptoms of a form of oral, head and neck cancer that is rapidly increasing in incidence.

The study, published online March 20, 2014 in JAMA Otolaryngology – Head & Neck Surgery, cites sore throat as the most likely initial symptom in patients with oropharyngeal squamous cell carcinoma (OPSCC) unrelated to human papillomavirus (HPV), while a lump in the neck is more likely in HPV-associated throat cancer.

“The prevalence of HPV-positive oropharyngeal squamous cell carcinoma has increased dramatically in young adults, a group traditionally at low risk for throat cancer,” said Terry Day, MD, President of the Head and Neck Cancer Alliance (HNCA) and a co-author of the study. “This study provides evidence supporting neck mass and sore throat as the initial symptoms of HPV-positive and HPV-negative oropharyngeal cancer, respectively. Our hope is that the results enable physicians and dentists the opportunity for detection and treatment of these tumors at earlier stages, giving patients a more favorable prognosis and quality of life, but that process must begin with screening.”

HPV has recently emerged as a leading cause of oropharyngeal (tonsil and base of tongue) cancer, particularly in non-smokers and younger age groups. It is thought that these cancers are related to oral sex. While the majority of all head and neck cancers are linked to tobacco and alcohol use, over half of tonsil and base of tongue cancers are linked to HPV.

“Unfortunately, many Americans do not recognize the symptoms of these life-threatening diseases, which include cancers of the oral cavity, larynx and pharynx, and by the time they are diagnosed, for some, it’s too late,” said Griffin Hospital's Ken Yanagisawa, M.D., an Ear, Nose and Throat (ENT) specialist and president elect of the CT ENT Society.
According to the American Cancer Society, an estimated 118,000 new cases of head and neck cancers will be diagnosed in 2014, resulting in an estimated 14,000 deaths.

These staggering statistics further underscore the need for screening because when oral, head and neck cancers are diagnosed early, these potentially deadly diseases can be more easily treated without significant complications, and the chances of survival increase. Many Americans do not recognize the symptoms of these cancers, which highlights the importance of everyone getting screened properly, not just those at high risk such as tobacco and alcohol users.

About Oral, Head and Neck Cancer (OHNC)

Oral, Head and Neck Cancer is a common form of cancer affecting any part of the oral cavity, pharynx, throat, thyroid and larynx (voice box). Regular check-ups can detect the early stages of head and neck cancer or conditions that may lead to it. For those cancers caught at a later stage, treatment is available and may require various combinations of surgery, radiation and/or chemotherapy.

Symptoms of Oral, Head and Neck Cancer include:

• A sore in your mouth that doesn’t heal
• Sore throat
• Lumps or patches in your mouth
• Trouble swallowing
• Changes in your voice, and a lump in your neck 

Tobacco (including smokeless tobacco) and alcohol use are very important risk factors for oral, head and neck cancers, particularly those of the tongue, mouth, throat and voice box. Chewing tobacco has been shown to cause mouth cancer. Cigarette smoking increases the risk of head and neck cancer by 15 times compared to a non-smoker.

Caucasians currently have the highest incidence rates of head and neck cancers, although death is still highest in African Americans. Men are affected about twice as often as women with oral cancer.More information regarding oral, head and neck cancer symptoms and risk factors can be found at www.headandneck.org.

10 Minutes That Can Save Your Life

The HNCA and Griffin Hospital are urging individuals who have sore throat or neck mass and all who may be at risk for these life-threatening cancers to take advantage of free oral, head and neck cancer screenings being held during the 17th annual Oral, Head & Neck Cancer Awareness Week (OHANCAW®), April 20-26. The Center for Cancer Care at Griffin Hospital, 350 Seymour Avenue, Derby, will offer FREE oral, head and neck cancer screenings on Tues., April 22 from 4 to 7 p.m. Register at 203.732.1280. Space is limited, so register early.

About the Study

Medical records from 88 patients were evaluated at the Head and Neck Tumor Center Multidisciplinary Clinic, Hollings Cancer Center, Medical University of South Carolina from January 1, 2008 to May 20, 2013. The study was designed to analyze the most common initial symptoms in patients with OPSCC and to determine if any differences in initial symptoms occur between HPV-positive and HPV-negative tumors. Researchers reviewed medical records of newly diagnosed, previously untreated OPSCC patients with documented HPV tumor status.  Initial symptoms (defined as the symptoms of longest duration when patient presented to his or her primary care physician) were extracted from all notes in the patient’s medical history. 

Neck mass, 44 percent, and sore throat, 33 percent, were the most common initial symptoms in OPSCC.  Patients who were HPV-positive were more likely to initially notice a neck mass than HPV-negative patients (51 percent vs. 18 percent), whereas HPV-negative patients were more likely to experience a sore throat (53 percent vs. 28 percent), dysphagia, trouble swallowing, (41 percent vs. 10 percent) or odynophagia, soreness when swallowing, (24 percent vs. 6 percent) when compared to HPV-positive patients.
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