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Early HPV testing could detect sexually transmitted oral cancer

No. 34 | 18/06/2013

Antibodies to a high-risk type of human papillomavirus (HPV16) could help detect oropharyngeal(1) cancer several years before the clinical onset of the disease, reveals a new study from the International Agency for Research on Cancer (IARC) in cooperation with the German Cancer Research Center (DKFZ) and the United States National Cancer Institute (NCI) in an article published online today by the Journal of Clinical Oncology.

Computer-simulation of HPV
© dkfz.de

According to the results of the study, HPV16 E6 antibodies in the blood indicate a very high risk of developing an HPV-associated cancer of the oropharynx.

“These results are very encouraging. Up to now, it was not known whether these antibodies were present in blood before the cancer became clinically detectable. If these results are confirmed, future screening tools could be developed for early detection of the disease,” explained Dr Paul Brennan, Head of the Genetics Section at IARC and the senior author of the study. “To date there are no available markers for early detection of this cancer,” he said.

In the new study, of the 135 individuals who developed oropharyngeal cancer, 47 (about one third) had HPV16 E6 antibodies in their blood up to 12 years before the onset of disease, compared with only 9 of 1599 individuals who did not develop the cancer (less than 1%). All participants were part of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which comprises more than 500 000 individuals from 10 European countries who were recruited in the 1990s and have been followed up since then.

Another significant finding of this landmark study was that patients with oropharyngeal cancer who had tested positive for antibodies against HPV16 E6 before cancer diagnosis were 3 times as likely to be alive 5 years after their diagnosis as those oropharyngeal cancer patients who had tested negative for these antibodies.

Although HPV is better known for causing cervical cancer and other genital cancers, it is also responsible for an increasing number of cancers of the oropharynx, particularly among men, and about 30% of oropharyngeal cancers worldwide are estimated to be HPV-related. The main type of HPV associated with these cancers is HPV16.

Oropharyngeal cancer has been a relatively uncommon cancer, traditionally associated with heavy tobacco smoking and heavy alcohol consumption. But over the past few decades its occurrence has increased dramatically in many parts of the world, especially in Europe and North America. This increase is thought to be due to the growing number of infections with HPV and to changing sexual practices, such as an increase in oral sex.

“These exciting findings are particularly important because of the worrying increase in the numbers of this type of cancer,” said Dr Christopher Wild, Director of IARC. “The work shows how innovative laboratory tests may help us develop tools to prevent or detect cancer early as well as improve treatment of the disease.”

(1) Oropharyngeal cancer includes cancers of the tonsils, the oropharynx (the oral part of the pharynx), the soft palate, and the base of the tongue.

Aimee R. Kreimer, Mattias Johansson, Tim Waterboer, et al. Evaluation of Human Papillomavirus Antibodies and Risk of Subsequent Head and Neck Cancer, Journal of Clinical Oncology 2013, DOI: 10.1200/JCO.2012.47.2738

The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) with its more than 3,000 employees is the largest biomedical research institution in Germany. At DKFZ, more than 1,300 scientists investigate how cancer develops, identify cancer risk factors and endeavor to find new strategies to prevent people from getting cancer. They develop novel approaches to make tumor diagnosis more precise and treatment of cancer patients more successful. DKFZ’s Cancer Information Service (KID) provides individual answers to all questions about cancer for patients, the general public, and health care professionals. Jointly with partners from Heidelberg University Hospital, DKFZ runs the National Center for Tumor Diseases (NCT) located in Heidelberg and Dresden, and, also in Heidelberg, the Hopp Children’s Cancer Center (KiTZ). In the German Cancer Consortium (DKTK), one of six German Centers for Health Research, DKFZ maintains translational centers at seven university partnering sites. Combining excellent university hospitals with high-profile research at a Helmholtz Center at the NCT and DKTK sites is an important contribution to the endeavor of translating promising approaches from cancer research into the clinic in order to improve the chances of cancer patients. DKFZ is a member of the Helmholtz Association of National Research Centers, with ninety percent of its funding coming from the German Federal Ministry of Education and Research and the remaining ten percent from the State of Baden-Württemberg.

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