ear, nose, and throat disorders
Oropharyngeal Squamous Cell Carcinoma
Introduction
Oropharyngeal cancer refers to cancer of the tonsil, base and posterior one third of the tongue, soft palate, and posterior and lateral pharyngeal walls. Squamous cell carcinoma comprises over 95% of oropharyngeal cancers. Tobacco and alcohol are major risk factors, but human papillomavirus (HPV) now causes most of these tumors. Symptoms include sore throat and painful and/or difficult swallowing. Treatment is with radiation, chemotherapy, or both, but primary surgery has begun to be used more often. Survival rate is much higher in HPV-positive patients. (See also Overview of Head and Neck Tumors .) In the US in 2020, there were an expected > 18,000 new cases of oropharyngeal cancer ( General reference ). Although the incidence of oropharyngeal cancer is increasing, its cure rates are also improving. The male:female ratio is > 2.7:1. HPV type 16 causes 60% of oropharyngeal cancers, and patients have become younger (median age 57 years, and bimodal peaks at 30 years and 55 years) as Human Papillomavirus (HPV) Infection has emerged as an etiology. The number of sex partners and frequency of oral sex are important risk factors. The risk of developing oropharyngeal cancer is 16 times higher in HPV-positive patients. In Europe and North America, HPV infection accounts for about 70 to 80% of oropharyngeal cancers. As with most head and neck cancers, non-HPV related oropharyngeal cancer is more common among older men, with a median age of 61. Tobacco and alcohol remain important risk factors for oropharyngeal cancer. Patients who smoke more than 1.5 packs/day have about a 3-fold increased risk of cancer, and patients who drink 4 or more drinks/day have about a 7-fold increased risk. People who both drink and smoke heavily have 30 times the risk of developing oropharyngeal cancer. 