Smoking and drinking have long been known as the main causes of head and neck cancer, often called the "silent cancer" due to the difficulty of early detection. But cases linked to human papillomavirus (HPV) infection are now rising rapidly.
Head and neck cancer refers to malignant tumors that develop in more than 30 sites, including the oral cavity (tongue), nasal and paranasal sinuses (nose), salivary glands, pharynx (tonsils), and larynx, excluding the brain and eyes, according to medical professionals Tuesday. More than 5,000 new cases are diagnosed annually in Korea.
Smoking and drinking have traditionally been regarded as the primary causes. About 70 to 85 percent of patients have a history of smoking, and combined smoking and drinking raises cancer risk by up to 15 to 20 times. Large-scale domestic cohort studies have also confirmed that men have a higher incidence of head and neck cancer than women.
But the landscape is shifting. Unlike in the past, more patients have no smoking history, and head and neck cancers related to HPV infection in particular are increasing rapidly worldwide. While HPV is commonly known as a cause of cervical cancer, it is also a major cause of head and neck cancers such as oropharyngeal cancer, including tonsil cancer and base of tongue cancer.
HPV is a virus transmitted through sexual contact. Head and neck cancer cases are increasingly emerging among younger age groups. HPV-related oropharyngeal cancer is already rising rapidly in the United States and Europe, and Korea is showing a similar pattern, with smoking-related head and neck cancers declining while HPV-related cancers are on the rise.
While smoking cessation and reduced alcohol consumption remain important for prevention, blocking HPV infection itself has emerged as a key priority. The most effective method is HPV vaccination.
Korea has recently implemented a policy change. Starting this month, free HPV vaccinations are being offered to 12-year-old male adolescents born in 2014. The move reflects the fact that HPV infects both men and women and causes various cancers including oropharyngeal cancer. HPV is known to be linked to more than 70 percent of oropharyngeal cancer cases worldwide.
"The HPV vaccine is most effective when administered before infection, so it is important to vaccinate around puberty, before sexual activity begins," said Park Jun-wook, head of the Head and Neck Cancer Center at Catholic University's Seoul St. Mary's Hospital and a professor of otolaryngology. "The need for vaccination has been relatively less emphasized for male students, but active vaccination is now necessary not only for their own health but also to reduce infections across society as a whole."
Head and neck cancer shows few early symptoms, so many cases are already advanced by the time they are discovered. The overall average five-year survival rate stands at 50 to 60 percent, indicating a poor prognosis. However, the cure rate is very high when detected early.
Patients who feel a lump in the neck, experience prolonged oral ulcers, or have a persistently hoarse voice should consult a specialist without delay.
