Why Head and Neck Cancer Is Increasing in Younger Adults
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You may have seen the headlines: Certain types of head and neck cancer are rising among younger adults. It’s a troubling trend, and understanding the reasons for it is important.
Head and neck cancers include cancers of the mouth (oral cancer), throat (pharyngeal cancer), and voice box (laryngeal cancer). Oropharyngeal cancers occur in the back of the throat, behind the tongue, including the tonsils, and the base of the tongue. In the past, these cancers were mainly caused by tobacco and alcohol use. As tobacco use declined in the United States, head and neck cancer cases were becoming less common.
But in recent decades, cases of head and neck cancer in the U.S. have been slowly but steadily rising, especially among younger adults. And while alcohol and tobacco use are still important risk factors, the current increase has another cause altogether: human papillomavirus (HPV) infections. About 70% of oropharyngeal cancers are HPV-related.
My patients with HPV-related head and neck cancers often have never smoked or used other forms of tobacco. The majority are men. And they tend to be younger (often in their 40s) than patients diagnosed with tobacco-related head and neck cancers, who are typically older than 50.
Why head and neck cancer is increasing
My patients are often surprised to learn that head and neck cancers are now the most common HPV-related cancer in the US.
That’s partly because cervical cancer rates have decreased, thanks to screening with Pap smears and HPV testing.
To understand why these head and neck cancers are increasing in the United States, it’s important to understand HPV.
HPV is a common sexually transmitted virus. As I tell my patients, it’s so common that most sexually active adults will be infected at some point in their lifetime— and because HPV usually doesn’t cause symptoms, they likely won’t know they have it.
Most of these infections will go away on their own without causing any problems. But some HPV infections linger, releasing certain proteins that, over a period of many years, cause cell growth and gene changes. That can cause cancer.
HPV spreads skin-to-skin, and it can be spread through all types of sexual contact, including contact with the genital areas, the mouth, and the throat.
Changes in sexual practices have led to an increase in the number of oral sex partners among North Americans. Increased numbers of partners can mean increased exposure to HPV. In the U.S., about 10% of men and about 3% of women have oral HPV, according to recent government figures.
That’s why it’s important for everyone to know the link between HPV and head and neck cancer — and how to spot the warning signs as soon as possible.
Early detection is important
It’s worth noting that HPV-positive head and neck cancers have a much better treatment success rate than those that are shown to not be caused by HPV. But, as I tell my patients, it’s usually easier to treat cancer successfully when we find it early.
That’s where greater awareness comes in. We don’t have routine screening tests for HPV-related oral cancers like we do for cervical cancer. But your dentist can check for oral cancers during checkups. They’re not able to see most cancers behind the tongue, like those in the throat. Still, they might spot some cancers early. That’s another great reason to get regular dental care.
It’s important to recognize the potential signs and symptoms of various head and neck cancers. Let your doctor know if you notice any of these red flags:
- A white or red patch on the gums, tongue, or lining of the mouth
- Nonhealing sores in the mouth
- Pain when swallowing
- Throat or neck pain that doesn’t go away
- Persistent ear pain on one side
- Trouble breathing or speaking
- Swelling or a lump in the neck
- Blood when you cough
An ounce of prevention
The HPV vaccine can help prevent HPV-related throat cancer. HPV vaccines don’t prevent cancer directly. Instead, they help prevent the types of HPV infections that can lead to cancer.
HPV vaccines are most effective before you’re exposed to the virus. That’s why it’s typically given to boys and girls who are between 11 and 12 years old.
But if you weren’t vaccinated as a child, it’s not too late. Adults 45 and younger can benefit from the HPV vaccine.
Don’t delay: The vaccine loses most of its benefit if you’ve already been exposed.
If you drink alcohol, you should also know that can raise your risk of head and neck cancers, especially if you also use tobacco.
Finally, the best way to reduce your risk of head and neck cancer is to avoid using tobacco in any form. If you do use tobacco, I hope you will give quitting your best shot. It’s not easy, but it’s worth it — and so are you. Ask your doctor for help, if you need it. Medications can make dealing with cravings easier.
A national leader in head and neck cancer treatment
Have you been diagnosed with head and neck cancer? Fox Chase Cancer Center offers specialized expertise in treating all types of head and neck cancer, even the most challenging tumors, in the least invasive way possible. And we are here to support patients and their families throughout their journey.
To see a head and neck cancer specialist at Fox Chase, call 888-369-2427 or request an appointment online.
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