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Head and neck squamous cell carcinomas.

Head and neck squamous cell carcinomas (HNSCCs) are of particular interest because of their good level of curability after multidisciplinary treatment. HNSCCs represent about 550 000 new cases each year around the world. In the US, there were 49 260 new cases in 2010 with 11 480 deaths. In Western countries, the incidence decreases with the efficient fight against tobacco, but in other countries the incidence increases nevertheless. Tobacco and alcohol intake are well-known risk factors. But in Sweden and other Western countries, the increase of incidence of orpharyngeal cancer and most tonsil cancers in young adults who never smoke or drink led to the discovery of a new etiologic factor: infection by human papillomavirus (HPV). Dr Psyrri describes this new etiology. Importantly, the prognosis of HPV + HNSCCs is better with better response to treatments and all future clinical trials will need to be stratified on HPV positivity.