# Surveillance of human papillomavirus through salivary diagnostics - A roadmap to early detection of oropharyngeal cancer men

## TL;DR

This paper reviews how human papillomavirus (HPV) can lead to oropharyngeal cancer in men and explores the potential of saliva-based diagnostics for early detection.

## Contribution

The paper provides a roadmap for using salivary diagnostics to detect HPV-related oropharyngeal cancer in men.

## Key findings

- Over 75% of oropharyngeal cancers are linked to HPV infection.
- Men are three times more likely than women to develop HPV-related oropharyngeal cancer.
- Current evidence is insufficient to determine if early screening improves outcomes for HPV-related oropharyngeal cancer.

## Abstract

Human papillomavirus (HPV) is the most common sexually transmitted disease. Certain strains have the potential to cause malignancy in multiple anatomical sites if not cleared by the immune system. In most infected people, HPV is cleared within two years. However, HPV may persist in susceptible individuals with certain risk factors, eventually leading to malignancy. New evidence suggests that over 75% of all oropharyngeal cancers (OPC) are directly attributable to HPV. It is estimated that prophylactic HPV vaccination alone may take at least 25 years to have a significant impact on reducing the incidence of OPC. The temporal link between detection of oral HPV, persistence of the infection and the subsequent development of OPC have been well established. Moreover, men have threefold higher risk than women for acquiring HPV-OPC. This comprehensive review focuses on OPC development in men, highlighting the risk factors associated with malignant transformation of HPV-OPC. Current evidence is insufficient to determine whether early identification of at-risk demographics, screening, and prompt diagnosis result in improved outcomes. Hitherto, the effectiveness of an oral HPV screening program in this regard has not been investigated. Nevertheless, the potential to emulate the success of the cervical screening program remains a very real possibility.