Human papillomavirus-positive<unk><unk>  <unk> -positive OPC or<unk> +OPC), is a<unk>  (squamous cell carcinoma) of the throat caused by the human papillomavirus type 16 virus <unk> 16). In the past,<unk>  of the oropharynx (throat) was associated with the use of alcohol or tobacco or both, but the majority of cases are now associated with the<unk>  virus, acquired by having oral contact with the genitals (oral-genital sex) of a person who has a genital<unk>  infection. Risk factors include having a large number of sexual partners, a history of oral-genital sex or anal–oral sex, having a female partner with a history of either an abnormal Pap smear or cervical dysplasia, having chronic periodontitis, and, among men, younger age at first intercourse and a history of genital warts.<unk> -positive OPC is considered a separate disease from<unk> -negative<unk><unk>  (also called<unk>  negative-OPC and<unk> -OPC).<unk> -positive OPC presents in one of four ways: as an asymptomatic abnormality in the mouth found by the patient or a health professional such as a dentist; with local symptoms such as pain or infection at the site of the tumor; with difficulties of speech, swallowing, and/or breathing; or as a swelling in the neck if the<unk>  has spread to local lymph nodes. Detection of a tumour suppressor protein, known as p16, is commonly used to diagnose an<unk>  associated OPC. The extent of disease is described in the standard<unk>  staging system, using the AJCC TNM system, based on the T stage (size and extent of tumor), N stage (extent of involvement of regional lymph nodes) and M stage (whether there is spread of the disease outside the region or not), and combined into an overall stage from I–IV. In 2016, a separate staging system was developed for<unk> +OPC, distinct from<unk> -OPC. Whereas most head and neck<unk> s have been declining as reduced smoking rates have declined,<unk> -positive OPC has been increasing. Compared to<unk> -OPC patients,<unk> -positive patients tend to be younger, have a higher socioeconomic status and are less likely to smoke. In addition, they tend to have smaller tumours, but are more likely to have involvement of the cervical lymph nodes. In the United States and other countries, the number of cases of<unk><unk>  has been increasing steadily, with the incidence of<unk> -positive OPC increasing faster than the decline in<unk> -negative OPC. The increase is seen particularly in young men in developed countries, and<unk> -positive OPC now accounts for the majority of all OPC cases. Efforts are being made to reduce the incidence of<unk> -positive OPC by introducing vaccination that includes<unk>  types 16 and 18, found in 95% of these<unk> s, prior to exposure to the virus. Early data suggest a reduction in infection rates. In the past, the treatment of OPC was radical surgery, with an approach through the neck and splitting of the jaw bone, which resulted in morbidity and poor survival rates. Later, radiotherapy with or without the addition of chemotherapy, provided a less disfiguring alternative, but with comparable poor outcomes. Now, newer minimally invasive surgical techniques through the mouth have improved outcomes; in high risk cases, this surgery is often followed by radiation and/or chemotherapy. In the absence of high quality evidence regarding which treatment provides the best outcomes, management decisions are often based on one or more of the following: technical factors, likely functional loss, and patient preference. The presence of<unk>  in the tumour is associated with a better response to treatment and a better outcome, independent of the treatment methods used, and a nearly 60% reduced risk of dying from the<unk> . Most recurrence occurs locally and within the first year after treatment. The use of tobacco decreases the chances of survival.
HPV-positive oropharyngeal cancer
Tobacco
Hepatitis C and HIV coinfection
Branchial cleft cyst
Circumcision and HIV
Oral florid papillomatosis
Hormone receptor positive breast tumor
Human papillomavirus infection