The most common symptoms for human papillomavirus-positive (HPV) throat cancer, formally known as oropharyngeal squamous cell carcinoma, are a neck mass and persistent sore throat, a new study finds.

Unlike the prevention efforts for many of the world’s known viruses, no blood test or Pap test exists to screen for HPV-positive throat cancer. Doctors must rely on their own observations to assess a patient’s risk, and patients must be equally diligent in getting screened, says senior author Dr. Terry Day, because throat cancer is increasingly occurring in young people. Other symptoms include pain or difficulty swallowing and difficulty opening the mouth, although these are typically signs of HPV-negative cancer.

"We want clinicians to tell their patients about the possibility of throat cancer,” Day said, according to Medscape Medical News, “and make them aware that patients with a sore throat lasting two weeks or more, trouble swallowing, or a lump in the neck should be referred to a specialist for exam and biopsy.”

Day, director of the Head and Neck Cancer Program at Medical University of South Carolina, first began to notice a growing number of patients coming to him with sore throats and neck lumps seven or eight years ago — before the national news of Michael Douglas’ HPV and throat cancer was ever inked in headlines. Patients had no idea the cancer even existed, Day remarked.

“Their physicians and dentists didn't know that the sore throat or neck lump was cancer, and these folks ended up going to 2 or 3 physicians or dentists before being sent a for a biopsy.”

Day’s latest research hopes to further popularize the cancer. He and a group of colleagues collected data on 88 patients with newly diagnosed throat cancer that was HPV-positive. Looking at the symptom data, he found the most common were overwhelmingly increased neck mass (44 percent) and chronic sore throat (29 percent). Those who were HPV-positive were more likely than negative patients to notice a neck mass, while HPV-negative patients were more likely to notice a sore throat.

Right now, only children and young adults are approved by the Food and Drug Administration to receive the HPV vaccine, although Day argues adults could also benefit if the research in the coming decade upholds the present findings’ trends. For now, the main goal is educating people. Alcohol and tobacco were once the main drivers of throat cancer, though the Centers for Disease Control and Prevention (CDC) now states HPV is the cause in roughly 63 percent of cases.

According to the CDC, an estimated 2,370 new cases of HPV-positive cancers are diagnosed in woman and 9,356 are diagnosed in men each year. White men are traditionally the most likely to be diagnosed with the form of throat cancer, although HPV more generally is thought to infect most sexually active people at least once in their lives, the CDC states. For those diagnosed with HPV-associated cancer, Day says the chances of survival are good.

"HPV-related oropharyngeal cancer tends to have a good cure rate, even when it has spread to the lymph nodes," he told Medscape Medical News. Meanwhile, HPV-negative cancers have a fairly low cure rate, emphasizing the importance of early screening.

 

Source: McIlwain W, Sood A, Nguyen S, Day T. Initial Symptoms in Patients With HPV-Positive and HPV-Negative Oropharyngeal Cancer. JAMA Otolaryngology — Head & Neck Surgery. 2014.