Based on the current literature associating human papillomavirus (HPV) with head and neck cancer, what public health initiatives need to be implemented? — Jeanette Pollard, APRN/PMH-BC

The incidence of head and neck squamous cell carcinoma (HNSCC) associated with human papillomavirus (HPV) has increased and is expected to continue to do so because of the prevalence of HPV infections and commonness of oral-genital sex in the overall population (Clin J Oncol Nurs. 2011;15[2]:165-170).

Given that more than 90% of diagnosed head and neck cancers are positive for HPV-16, public health initiatives should focus on primary levels of prevention based on the unique behaviors of HPV-associated cancers such as demographic, behavioral, and clinical characteristics (J Natl Compr Canc Netw. 2011;9[6]:665-673). These cancers tend to be prevalent in middle-aged white men of medium to high socioeconomic status and among those participating in oral sex behaviors. Public health initiatives should target prevention efforts that consider premalignant oropharyngeal conditions, early cancer screenings, and a consistent approach to HPV testing, especially for persons with high risk factors. — Jiajoyce R. Conway, DNP, FNP-BC, AOCNP®, NP-C