Chronic Mouth Inflammation May Increase Risk of Head and Neck Cancers

A history of gum disease (periodontitis) may be associated with an increased risk of tumors positive for human papillomavirus (HPV) among patients with head and neck squamous cell carcinomas (SCC).

According to the National Cancer Institute, the incidence of oropharyngeal cancers has steadily increased in the United States since 1973, despite a significant decline in tobacco use since 1965. Study authors attribute the increase to oral HPV infection.

According to a report published Online First by Archives of Otolaryngology – Head & Neck Surgery, Mine Tezal, DDS, PhD, of the University at Buffalo, and colleagues evaluated data from 124 patients diagnosed with primary SCC of the oral cavity, oropharynx, and larynx between 1999 and 2007.

Of the 124 primary cases of head and neck SCC, 31 (25%) were in the oral cavity, 49 (39.5%) in the oropharynx, and 44 (35.5%) in the larynx. Of the 124 tumor samples, 50 (40.3%) were positive for HPV-16 DNA. A higher percentage of oropharyngeal cancers were HPV-positive (65.3%) compared with oral cavity (29%) and laryngeal (20.5%) cancers, according to the study authors.

Periodontitis history was assessed by millimeters of alveolar bone loss (ABL) from available tissue samples and dental records. A significantly higher ABL was seen among patients with HPV-positive tumors compared with patients with HPV-negative tumors. Each millimeter of ABL was associated with 2.6 times increased odds of HPV-positive tumor status after adjustment for other factors. This association was greater among patients with oropharyngeal SCC compared with those with oral cavity SCC and laryngeal SCC.

“Periodontitis is easy to detect and may represent a clinical high-risk profile for oral HPV infection,” the authors conclude. “Prevention or treatment of sources of inflammation in the oral cavity may be a simple yet effective way to reduce the acquisition and persistence of oral HPV infection.”

Source: NCI.