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oral cancer (oropharyngeal cancer)

Etiology: - most are related to alcohol &/or tobacco - HPV-16 infection may be associated with oropharyngeal squamous-cell carcinoma [4] - tobacco use is associated with increased risk of HPV-16 infection [4] - dental trauma is suggested as a cause in non-smokers [5] - inflammatory bowel disease increases risk of oral cancer 9-12 fold [8] Epidemiology: - 9th most common cancers in US - oropharyngeal cancer is the most prevalent HPV-related cancer in the US [11] Pathology: - vast majority are squamous cell carcinomas - most frequently found on the edge of the tongue [5] - salivary gland neoplasms - lymphomas - Kaposi sarcoma - mucosal melanoma (rare) Genetics: - overexpression of ORAOV1 - other implicated genes TP53, CLCA4 Laboratory: - cell-free tumor DNA in urine may detect HPV+ oropharyngeal cancer [10] Management: - see head & neck cancer & squamous cell carcinoma of the mouth Follow-up: - direct physical examination +/- laryngoscopy [1] Screening: - not enough evidence to recommend screening for oral cancer in primary care [2] - does not apply to dentists or otolaryngologists [2]

Related

nasopharyngeal carcinoma (NPC)

Specific

lip cancer squamous cell carcinoma of the mouth

General

head & neck cancer (HNC) oral neoplasm (oropharyngeal neoplasm)

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018, 2021.
  2. U.S. Preventive Services Task Force Screening for Oral Cancer: U.S. Preventive Services Task Force Recommendation Statement. DRAFT. Summary of Recommendation and Evidence http://www.uspreventiveservicestaskforce.org/draftrec2.htm - Moyer VA et al Screening for Oral Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. Published online 26 November 2013 PMID: 24276469 http://annals.org/article.aspx?articleid=1783292
  3. Szabo E. Assessing efficacy in early-phase cancer prevention trials: the case of oral premalignancy. Cancer Prev Res (Phila). 2008 Oct;1(5):312-5. PMID: 19138975
  4. Fakhry C et al Tobacco Use and Oral HPV-16 Infection. JAMA. 2014;312(14):1465-1467 PMID: 25291584 http://jama.jamanetwork.com/article.aspx?articleid=1911314
  5. Perry BJ et al Sites of Origin of Oral Cavity Cancer in Nonsmokers vs Smokers. Possible Evidence of Dental Trauma Carcinogenesis and Its Importance Compared With Human Papillomavirus. JAMA Otolaryngol Head Neck Surg. November 06, 2014 PMID: 25375930 http://archotol.jamanetwork.com/article.aspx?articleid=1921367
  6. Chaturvedi AK, Engels EA, Pfeiffer RM et al Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011 Nov 10;29(32):4294-301. PMID: 21969503
  7. Gunn GB, Frank SJ. Advances in radiation oncology for the management of oropharyngeal tumors. Otolaryngol Clin North Am. 2013 Aug;46(4):629-43 PMID: 23910474
  8. Katsanos KH et al. Increased risk of oral cancer in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 2015 Oct 20; S1542-3565(15)01417-2 PMID: 26499929
  9. Chaturvedi P, Singh A, Chien C-Y et al. Tobacco related oral cancer. BMJ. 2019;365:l2142. PMID: 31167798 https://www.bmj.com/content/365/bmj.l2142
  10. Stewart J Urine Tests Could Be 'Enormous Step' in Diagnosing Cancer. Medscape. May 21, 2024 - Bhambhani C, Kang Q, Hovelson DH et ak ctDNA transiting into urine is ultrashort and facilitates noninvasive liquid biopsy of HPV+ oropharyngeal cancer. JCI Insight. 2024 Feb 8;9(6):e177759. PMID: 38516891 PMCID: PMC11018327 Free PMC article. https://insight.jci.org/articles/view/177759
  11. Senkomago V, Henley SJ, Thomas CC, Mix JM, Markowitz LE, Saraiya M. Human papillomavirus-attributable cancers - United States, 2012-2016. MMWR Morb Mortal Wkly Rep. 2019;68:724-728 PMID: 31437140 PMCID: PMC6705893 Free PMC article
  12. National Institute of Dental and Craniofacial Research Oral Cancer https://www.nidcr.nih.gov/health-info/oral-cancer