HPV: Local Knowledge toward Prevention of Head and Neck Cancer


There are three vaccines against the human papilloma virus (HPV): bivalent, quadrivalent, and nonavalent. They are all safe and effective options to prevent several types of cancer caused by this pathogen: cancer of the cervix, vulva, vagina, penis, anus and their precursors. Moreover, on June, 2020, the use of the nonavalent vaccine was approved in the United States to prevent head and neck cancers. However, this vaccine is not yet available in most Latin American countries, nor is it approved for this same use. For this to happen in the future, local information about the impact of this disease needs to be gathered in each country to analyze the benefits of vaccinating the population to reduce this impact. FIDEC contributes to the information-gathering process by sponsoring the study Head and Neck Cancers, and Other HPV-Associated Cancers of the Upper Respiratory Tract. Prevalence Among a Population Sample of Argentina.

“Our main goal is to determine the percentage of patients with these types of cancer who test positive for the HPV virus in samples of malignant lesions,” explained Hebe Vázquez, Infectious Disease Specialist at FIDEC and Principal Investigator of this study. Likewise, they set to identify the infection risk factors of these patients.

HPV infection is one of the most common sexually transmitted diseases in the world. Aside from the number of people that get infected every year, it has an important economic burden on the healthcare system. It is prevalent in people of all sexual orientations. Most frequently, the virus is transmitted through vaginal and anal sex, but it can also be transmitted through oral sex and contact between outer genital areas. As condoms are not able to cover all the possible infected or infection-prone areas, using it adequately and in every sexual intercourse can only reduce HPV transmission, but it cannot prevent it. Thus, most countries in the world have introduced the vaccine to prevent these infections, which go unnoticed in most cases because the immune system eliminates the virus. If this is not the case, benign or malignant lesions may appear, depending on the type of HPV virus (see box).

Volunteers for this study have some sort of malignant lesion in their mouth, throat (pharynx), larynx, or nasal cavity. Researchers open a chart for each patient, where they record data on these lesions, recent sexual activity, previous lesions and how they were treated, history of HPV vaccination, and the result of the HPV test in the current lesion. Molecular biology tests are used for diagnostics.

“Once we analyze the data from all patients as a whole, we will be have a clearer picture of these types of cancer in Argentina and how they relate to HPV. For now, there is insufficient data for our country,” Vázquez pointed out. This information shall contribute to setting the necessary bases for vaccines against this virus to be used in the future to prevent oropharyngeal cancer and other upper respiratory tract tumors.

The study started in June, 2019, and is expected to include 277 adult participants from the Metropolitan Area of Buenos Aires. “So far, we have studied 80 patients, less than expected, due to the pandemic. We will thus extend the study for some more months,” Vázquez added.

Under the coordination of Doctor Vázquez and the direction of Daniel Stamboulian, the research group is made up of Lorenzo and Santiago Parreño, Subinvestigators and Ear, Nose and Throat Specialists; Marina Gutiérrez, PhD in Biological and Life Sciences, and Molecular Biology Specialist; Graciela Lozano, Pathology Specialist; Gustavo Kardjian, Administrative Coordinator; and Ana Paula Cordero, Communications Coordinator. Participating institutions are Stamboulian Servicios de Salud, Atención Otorrinolaringológica (Atención OLR), and Hospital de Clínicas José de San Martín, in the City of Buenos Aires.

Did you know?

  • In 2012, there were 14 million new cases of cancer in the world, 15.4% of which were caused by infectious agents.
  • The second most frequent pathogen was the human papilloma virus (HPV).
  • There are different types of HPV, classified into two large groups: low-risk and high-risk viruses.
  • HPV 16 and 18, both high-risk viruses, are behind more than 70% of malignant cervical lesions.
  • High-risk HPVs are also associated to anal cancer (90% of cases), cancer of the outer genitals (vulva, vagina, and penis; 40-50% of cases), and oropharyngeal cancer (cancer of the mouth, pharynx, larynx; 30-70% of cases).
  • Cases of HPV-caused cancer of the mouth, pharynx, or larynx are on the rise.
  • Three HPV vaccines are currently available: bivalent, quadrivalent, and nonavalent.
  • The bivalent vaccine prevents infections by HPV 16 and 18.
  • The quadrivalent vaccine prevents infections by those two viruses and by two other HPVs, which cause benign lesions (genital warts and laryngeal papillomatosis).
  • The nonavalent vaccine broadens the protection of the quadrivalent vaccine by also preventing infections by five other high-risk HPVs.