[Cancer of the upper aero-digestive tract: elevated incidence in Belgium, new risk factors and therapeutic perspectives].

Abstract

The squamous cell carcinomas of the upper aero-digestive tracts are frequent cancers, with as much as 466831 and 168368 cases diagnosed in 2008 among men and women in the world, respectively. As such, they make up the sixth most frequent neoplasia among men and the eighth among women. Their frequency shows interesting variations covering the last twenty years, with an ascending tendency among women, which is maximal in Europe, and a descending tendency in men, maximal in the USA. The comparison with the Belgian official data reveals a striking elevation of incidence of these cancers among both sexes. Although the causal link between high-risk HPVs and cervical carcinoma is well-established, the implication of this viral infection in HNSCC remains debatable. 5 % to 65 % of head and neck cancers could be associated with oncogenic HPVs, in particular HPV type 16. The oropharynx--more precisely the tonsil--is the head and neck location presenting the highest incidence of HPV infection. Moreover, a clear increase of tonsillar carcinoma incidence has been described. As observed in cervical carcinomas, HPV positive HNSCCs are sexually transmitted and characterized by alterations of p53 and pRb signalling pathways. New studies regarding HPV status in HNSCCs are warranted to provide a rationale for large scale HPV vaccination in young male populations.