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The Epidemiology and Risk Factors of Head and Neck Cancer: a Focus on Human Papillomavirus

¹ Departments of Human Genetics and
² Epidemiology, the University of Pittsburgh Graduate School of Public Health, 130 DeSoto Street, Room A300,
³ Otolaryngology, and Pathology, the University of Pittsburgh School of Medicine,
⁴ the Head and Neck SPORE at the University of Pittsburgh, and the
⁵ University of Pittsburgh Cancer Institute, Pittsburgh, PA 15261, USA

View larger version (35K): [in this window] [in a new window]   Figure. The multifactorial model of HNSCC carcinogenesis. Tobacco- and alcohol-related head and neck tumors are predominantly negative for HPV. However, there may be a subset of HPV-positive tumors in which the virus may (in E6/E7 expressors) or may not (in E6/E7 non-expressors) play a role in carcinogenesis. In the absence of tobacco and alcohol use, head and neck tumors may or may not be positive for HPV. The virus may function as a carcinogen in those tumors that express E6/E7. Risk factors other than HPV may account for the development of HPV-negative as well as HPV-positive, E6/E7 non-expressing tumors.