Each year, about 68,000 Americans will be diagnosed with cancer in the head or neck. For many years, the highest risk factors for head or neck cancer were alcohol and tobacco use, but in more recent years, another factor has been on the rise—human papillomavirus.

What are the types of head and neck cancers?

The head and neck are made up of many different parts, and not all cancers in that area are considered head or neck cancers. Head and neck cancers are those that appear in the mouth, throat, larynx or voice box, sinuses, tongue, or salivary glands. Cancer in the brain, eyes, skin, esophagus, and thyroid are not considered head or neck cancers.

Head and neck cancers are more than twice as common among men as they are women, and historically are diagnosed most often in people over the age of 50.

What causes head and neck cancers?

Alcohol and tobacco use, including secondhand smoke and chewing tobacco, have been the two most important risk factors for head and neck cancers, especially cancers of the mouth, pharynx, and larynx. Combining alcohol and tobacco use increases the risk of cancer compared to using only alcohol or tobacco.

That is starting to change, however. People who have been infected with cancer-causing types of human papillomavirus, or HPV, are at risk for oropharyngeal cancer, or cancer in the middle of the throat, right behind the mouth. While not all forms of HPV cause cancer, certain strains of the virus can lead to a variety of cancers.

Head and neck cancer linked to HPV is being diagnosed more often in younger, nonsmoking patients with no prior history of heavy alcohol use. The CDC reports that about 10 percent of men and 3.6 percent of women have oral HPV, and currently, researchers estimate that 70 percent of oropharyngeal cancers diagnosed in the United States are caused by oral HPV infections. Most people with oral HPV will clear the infection without lingering effects, but those with cancer-causing strains are at risk for oropharyngeal cancer. The American Cancer Society reports that between 2015 and 2019, the number of people diagnosed with HPV-linked oropharyngeal cancer rose 1.3 percent in women and 2.8 percent in men.

What are the symptoms of oropharyngeal cancer caused by HPV?

The symptoms of cancer caused by HPV are different than those head and neck cancers caused by tobacco and alcohol use. Symptoms typically include a long-lasting sore throat, hoarseness, enlarged lymph nodes, pain when swallowing, earaches, and unexplained weight loss.

Since HPV-linked head and neck cancers are showing different symptoms and are appearing in younger populations, these cancers are often misdiagnosed initially. Routine visits to primary care physicians and dentists can help with early detection and diagnosis of oropharyngeal cancer.

How are head and neck cancers treated?

When caught early, many head and neck cancers can be treated and cured. There are a variety of treatment options available, depending on the type of cancer, location, the extent of the cancer, and the patient’s age and general health. These treatment options include surgery and minimally invasive surgery, radiation, and chemotherapy. After treatment, reconstructive surgery may be needed to help patients regain normal function and appearance.

At the Lifespan Cancer Institute, our multidisciplinary approach to treating head and neck cancers treats the patient as a whole – not just the disease. Our team of oncologists, radiologists, surgeons, pathologists, and nurses work together to ensure that patients receive treatment options that are tailored to their diseases and their needs from diagnosis to recovery.

Learn more about the Head and Neck Cancer Multidisciplinary Clinic on our website.

Ariel E. Birnbaum, MD

Dr. Ariel Birnbaum is a medical oncologist with the Lifespan Cancer Institute at Rhode Island Hospital