The EUROGIN 2012 roadmap is focused on the comparative epidemiology of human papillomavirus (HPV) associated head and neck
squamous cell cancers (
HNSCC) and
cervical cancers. Discussed are the similarities and differences between the two
cancers with regard to global disease burden, HPV prevalence and type distribution, disease cofactors, molecular pathogenesis, treatment approaches, prognostic factors and primary and
secondary prevention. The global incidence of
HNSCC and
cervical cancer is similar; however, a minority of
HNSCC in comparison to virtually all
cervical cancers is caused by HPV.
HPV infection prevalence is considerably lower in the oral than genital regions for reasons that are as yet unclear.
Infection at both sites is strongly associated with sexual behavior, but this association does not appear to explain the male predominance of oral
HPV infection. Studies of the molecular pathogenesis of HPV-associated
HNSCC (predominantly
oropharyngeal cancers) are hampered by the lack of a readily detectable intermediate clinical endpoint analogous to cervix intraepithelial
neoplasia. Nevertheless, similarities in
chromosomal aberrations, gene expression, methylation and
microRNA profiles between HPV-positive
HNSCC and
cervical cancer argue for shared carcinogenic pathways. Treatment approaches to oropharyngeal and
cervical cancers are remarkably similar, with the development of HPV-targeted
therapies as the ultimate treatment goal. Key research challenges include understanding oral HPV transmission and male predominance, clarifying the role of cofactors, and developing new screening and treatment methods for HPV-associated
HNSCC.