HPV raises esophageal cancer risk

The human papillomavirus (HPV) triples the risk of people developing yet another cancer, esophageal squamous cell carcinoma (ESCC), according to new research. In addition to causing cervical, anal, and genital cancer, HPV has also recently been found to cause some head and neck cancers.

"One of the main issues is this form of esophageal cancer is usually diagnosed quite late and so has a very high mortality," said first author Surabhi Liyanage, a PhD candidate with the School of Public Health and Community Medicine, at the University of New South Wales (UNSW) in Australia.

ESCC is the most common of two types of esophageal cancer. While it is rare in Australia, it is the sixth highest cause of cancer-related deaths worldwide. It is particularly prevalent in China, South Africa, and Iran among men in their mid 70s to 80s. It is unknown why the prevalence is so high in those countries, but it is thought to be linked to dietary, lifestyle, and environmental factors.

"HPV is another factor which we can add to a long list of causes of ESCC," said Liyanage. "Smoking and alcohol are the main causes, as well as the consumption of extremely hot liquids, lots of red meat, and possibly environmental toxins in the diet."

The findings, published in PLOS ONE (2013; doi:10.1371/journal.pone.0069238), could have implications for vaccination programs around the world. This study's findings resolve a previous uncertainty about HPV and ESCC.

The two most common HPVs that cause cervical cancer are preventable by vaccination, so these findings may be significant in countries where ESCC is prevalent.

The vaccine against HPVs is currently used most commonly in young people in developed countries to prevent cervical cancer. Notably, this study may be considered in China, where ESCC is one of the leading causes of cancer death.

"Time will tell whether our universal HPV vaccination program has any additional benefit in prevention of cancers other than cervical cancer," said the study's senior author, Professor Raina MacIntyre, also of UNSW.
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