HPV-Related Head and Neck Cancers Now Most Common HPV Malignancy in U.S.

Twenty years after the approval of a safe and highly effective vaccine against human papillomavirus (HPV), head and neck cancers have emerged as the most common HPV-related cancer in the United States. The virus now causes more than 49,000 cancers a year, including tumors of the head and neck, cervix, vagina, vulva, penis, and anus.

While HPV leads to 11,100 cervical cancers each year, the virus causes 16,000 cancers in the head and neck, according to the Centers for Disease Control and Prevention. The incidence of HPV-related head and neck cancers tripled from 2000 to 2017, research shows.

HPV-related head and neck cancers tend to develop in the throat, the base of the tongue, and the tonsils. While cervical tumors can be found in early or even precancerous stages during routine screenings, there is no established early detection method for head and neck cancers. As result, head and neck cancers are typically detected in later, less curable stages.

Although doctors are seeing fewer head and neck cancers caused by tobacco and alcohol use—the traditional risk factors for the disease—they're seeing more patients with HPV-related cancers. Researchers believe that increases in HPV-related head and neck cancers are related to changes in sexual practices that help transmit the virus. HPV is transmitted through sexual contact; the virus can spread to the throat and tonsils through oral sex or intimate kissing.

Because head and neck cancers take many years to appear, most cases appear in men in their 40s, 50s, and 60s—decades after they were first exposed to HPV, and long before vaccines were available.

One patient, a 66-year-old man, discovered a malignant mass on the right side of his throat during a routine scan. Further testing revealed the mass was caused by HPV. "Something I'd never heard of almost killed me," the patient said. He had no symptoms of cancer—no pain, no difficulty breathing or swallowing.

Tests revealed his cancer was stage 4, the most advanced phase. In addition to the tumor in his throat, doctors also found cancer on the base of his tongue and on his tonsils. When doctors operated, they removed a tumor the size of a golf ball, along with 35 lymph nodes. Over the next 18 months, he underwent chemotherapy, radiation, and additional surgeries, including the removal of a mass on his tongue.

Therapy for head and neck cancers is notoriously difficult. The patient was unable to complete treatment with one of his chemotherapy drugs, which weakened his immune system and led to an Escherichia coli (E. coli) infection. He was hospitalized three times and heavily treated with antibiotics.

The best hope for reducing suffering and death from HPV-related head and neck cancers is prevention. The American Academy of Pediatrics recommends vaccinating children against HPV from ages 9 to 12 years. About 79% of girls and 77% of boys ages 13 to 17 had received at least one dose of HPV vaccine in 2024, while 64% of girls and 62% of boys had received all recommended doses.

When the vaccine was first approved in 2006, it was promoted as a way to prevent cervical cancer, which was then the most common type of HPV-related tumor. Routine screenings and vaccinations have since reduced the incidence of HPV-related cervical cancers, contributing to the shift toward head and neck tumors becoming the predominant HPV-related malignancy.