White Paper High-Risk Patients Part 2

Early detection of HPV16-induced tumours

Guidelines for identifying high-risk patients

Partners of patients with HPV-induced tumours

Partners of patients with cervical carcinoma

Partners of patients with cervical carcinomas develop tumours in parts of the mouth and throat up to three times more frequently than the general population. Figure 1 shows study data collected for partners of patients with cervical cancer in situ and invasive cervical cancer.

Although the data is clear, it is rare that partners of affected patients are informed about their risk and that regular examinations are initiated. Pharyngeal tumours in particular  are usually discovered in an advanced stage.

However, early detection of a tumour in the mouth and throat can reduce the extent of necessary therapeutic interventions. The risk of tumour development in the male partner remains elevated for several years after the diagnosis of a cervical tumour in the female patient (see Figure 1).

Partners of patients with HPV-induced oropharyngeal carcinomas

In doctors’ practices, partners of patients with HPV16 positive oropharyngeal carcinoma are noticed if, like their partners, they also develop HPV16-induced tumours. As yet, there isn’t as much data to draw on about the prevalence of oral and pharyngeal cancer in partners of patients with oropharyngeal cancer as for patients with cervical carcinomas and their partners.

However, in one study genome analysis was informative. In one couple, where both suffered from oropharyngeal carcinoma, the analysis showed that the oncogenic virus in the tumours of both partners was genetically nearly identical.2

The time between the occurrence or the diagnosis of tumours in both partners can be very short. The shortest time interval, according to a report by experts of the Mayo Clinic in the USA was 2 months.2

Recommendations for the doctor’s practice

As part of tumour aftercare, it is advisable to integrate partners and/or family members into a preventive concept. We recommend:

  • Inform partners of patients with cervical carcinomas about the availability of early detection for HPV-induced cancer, and use regular screening for HPV-induced carcinomas, especially in the mouth and throat area
  • Recommend regular, short-interval screening for HPV-induced tumours to the male and female partners of patients with HPV-induced mouth and throat cancer, so that HPV-induced tumours, especially in the oropharyngeal region, can be detected in time.

References:

1. K Hemminki, C Dong, M Frisch: Tonsillar and other upper aerodigestive tract cancers among cervical cancer patients and their husband; European Journal of Cancer Prevention 2000, 9, 433]437 (Received 16 September 2000; accepted 6 October 2000)

2. Tyler D. Brobst, Joaquín J. García Katharine A. Price, Ge Gao, David I. Smith, and Daniel L. Price: Case Report; Concurrent Human Papillomavirus-Positive Squamous Cell Carcinoma of the Oropharynx in a Married Couple; Case Reports in Otolaryngology; Volume 2016, Article ID 8481235, 4 pages