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HPV cancers are on the rise and the inci- References 17. Saraiya M, Unger ER, Thompson TD, Lynch
dence is projected to continue to increase 1. https://seer.cancer.gov/: Cancer of the Oral CF, Hernandez BY, Lyu CW, Steinau M, Watson
M, Wilkinson EJ, Hopenhayn C, Copeland
18
in the future. Because of the increased Cavity and Pharynx - Cancer Stat Facts. 2019. G, Cozen W, Peters ES, Huang Y, Saber MS,
incidence of HPV positive oropharyngeal 2. https://seer.cancer.gov/: Cancer of the Cervix Altekruse S, Goodman MT: US assessment of
cancers and other cancers, the Centers For Uteri - Cancer Stat Facts. 2019. HPV types in cancers: implications for current
Disease Control have recommended that 3. Anonymous HPV | For Clinicians | Vaccination and 9-valent HPV vaccines. J Natl Cancer Inst
now boys also should get vaccinated with Schedules and Recommendations | CDC. 2019, 107, 2015.
3
the HPV vaccine. HPV cancers of the oro- 2019. 18.https://www.cancer.net/cancer-types/oral-
pharynx affect young males more frequent- 4. Cohen LA: Expanding the Physician’s Role in and-oropharyngeal-cancer/statistics: Oral and
ly than females with the incidence being 4-6 Addressing the Oral Health of Adults. American Oropharyngeal Cancer - Statistics. 2019, 2012.
times higher in males than females. These Journal of Public Health 103:408, 2013. 19. Viens LJ, Henley SJ, Watson M, Markowitz
patients often have no additional risk factors 5. Park SE, Donoff RB, Saldana F: The Impact of LE, Thomas CC, Thompson TD, Razzaghi H,
19
such as smoking. Saraiya M: Human Papillomavirus-Associated
Integrating Oral Health Education into a Medical
Curriculum. Med Princ Pract 26:61, 2017. Cancers - United States, 2008-2012. MMWR
These lesions may present as a leukopla- 6. Anonymous Screening for Oral Cancer: Morb Mortal Wkly Rep 65:661, 2016.
kia or redness in the soft palate, back of Recommendation Statement. American Family 20. https://oralcancerfoundation.orgunderstanding/
the throat, or as asymmetric tonsils. Many Physician 91:388A, 2015. hpv/hpv-oral-cancer-facts/: HPV / Oral Cancer
times the first presenting sign is a palpa- Facts.
ble neck node. Thus it is important for the 7. Abadeh A, Ali AA, Bradley G, Magalhaes 21. Ang KK, Harris J, Wheeler R, Weber R,
MA: Increase in detection of oral cancer and
oral healthcare provider to ensure that the precursor lesions by dentists: Evidence from an Rosenthal DI, Nguyen-Tân PF, Westra WH,
neck exam is a routine part of their physical oral and maxillofacial pathology service. J Am Chung CH, Jordan RC, Lu C, Kim H, Axelrod
20
exam. Dent Assoc 150:531, 2019. R, Silverman CC, Redmond KP, Gillison ML:
Human papillomavirus and survival of patients
8. Young L: Oral cancer screening should be with oropharyngeal cancer. N Engl J Med
Oropharyngeal cancers that harbor the HPV mandated for dental profession. 2019, 2018. 363:24, 2010.
virus (HPV positive) usually tend to have
a better prognosis than oropharyngeal can- 9. Poh CF, Williams PM, Zhang L, Rosin MP: 22. Lydiatt WM, Patel SG, O’Sullivan B,
cers that are HPV negative. In fact the Heads up! - a call for dentists to screen for oral Brandwein MS, Ridge JA, Migliacci JC, Loomis
21
cancer. J Can Dent Assoc 72:413, 2006.
th
8 edition of the AJCC staging system was AM, Shah JP: Head and neck cancers—major
changes in the American Joint Committee on
updated to reflect the better prognosis of 10. Rivera C: Essentials of oral cancer. Int J Clin cancer eighth edition cancer staging manual. CA:
22
HPV positive cancers. Routine testing Exp Pathol 8:11884, 2015. A Cancer Journal for Clinicians 67:122, 2017.
of the oral cavity for HPV doesn’t seem to 11. Papageorge MB: Etiology of oral cancer in
be a helpful tool at this time as 26 million the young patient: is tongue cancer becoming the 23. Weinstein GS, Quon H, Newman HJ,
Chalian JA, Malloy K, Lin A, Desai A, Livolsi
American have an oral HPV infection on other cancer in women? Oral Maxillofac Surg VA, Montone KT, Cohen KR, O’Malley
any given day. The vast majority will clear Clin North Am 19:163, 2007. BW: Transoral Robotic Surgery Alone for
the virus and not know they were exposed 12. Ord RA, Isaiah A, Dyalram D, Lubek JE: Oropharyngeal Cancer: An Analysis of Local
20
it. Treatment of oro-pharyngeal cancers Is Long-Term Follow-Up Mandatory for Stage Control. Archives of Otolaryngology–Head &
usually involves radiation and chemother- I Oral Tongue Cancer? J Oral Maxillofac Surg Neck Surgery 138:628, 2012.
apy. Smaller lesions that are amenable to 76:2676, 2018.
surgical resection may undergo surgery of- 13. Scully C, Bagan J: Oral squamous cell Mohammed Qaisi, DMD,
MD, FACS is Professor
23
ten utilizing robotic surgery. carcinoma overview. Oral Oncol 45:301, 2009.
and residency program di-
14. Awadallah M, Idle M, Patel K, Kademani D: rector of the Oral & Max-
In closing, oral health care providers play Management update of potentially premalignant illofacial Surgery Program
a pivotal role in the early detection of oral oral epithelial lesions. Oral Surg Oral Med Oral at Cook County Health
and oropharyngeal cancers. Early detection Pathol Oral Radiol 125:628, 2018. (Chicago, IL). He received
is the single most important factor that af- 15. Kharma MY, Tarakji B: Current evidence his medical degree from
fects patient survival. Routine palpation of in diagnosis and treatment of proliferative Louisiana State University School of Medi-
the neck and thorough examination of the verrucous leukoplakia. Annals of Saudi medicine cine- Shreveport, and his dental degree from
oral cavity should be performed. Should a 32:412, 2012. Boston University Goldman School of Den-
tal Medicine. Following residency training
suspicious lesion of two weeks duration or 16. Lingen MW, Abt E, Agrawal N, Chaturvedi in Oral & Maxillofacial surgery, Dr. Qaisi
more be picked up on exam, an immediate AK, Cohen E, D’Souza G, Gurenlian J, Kalmar completed a two year fellowship in Head &
scalpel biopsy or referral to an oral surgeon JR, Kerr AR, Lambert PM, Patton LL, Sollecito Neck Oncology and Microvascular Recon-
or maxillofacial oncologist should be initi- TP, Truelove E, Tampi MP, Urquhart O, structive Surgery (Maxillofacial Oncology)
ated. Banfield L, Carrasco-Labra A: Evidence-based at the University of Maryland Greenebaum
clinical practice guideline for the evaluation of Cancer Center. Dr. Qaisi is a Diplomate of
potentially malignant disorders in the oral cavity: the American Board of Oral & Maxillofacial
A report of the American Dental Association. J Surgery and a Fellow of the American Col-
Am Dent Assoc 148:712, 2017.
lege of Surgeons.
www.nysagd.org l Spring 2020 l GP 29