Patients with HPV-positive head and neck cancer who also smoke are likely to experience worse outcomes, according to a study published in Clinical Cancer Research (2010 Feb 15;16(4):1226-35).

Researchers from the University of Michigan Comprehensive Cancer Center conducted a study involving 124 patients with advanced oropharyngeal cancer, with the majority of participants having HPV DNA in their tumors. All 22 of the HPV-negative patients were tobacco users, and about two-thirds of the 102 HPV-positive patients were current or former tobacco users.

The study revealed that patients with HPV-positive tumors were 5 times more like to have their cancer return if they were current tobacco users.  Of the HPV-positive patients who had never used tobacco, 6% had a recurrence of their cancer. Researchers also reported that 19% of former tobacco users and 35% of current tobacco users had a recurrence.

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“Because the effect of HPV is so strong in giving a very good prognostic picture, we were surprised to find that smoking remained a huge issue, and it actually affected the outcome in patients who smoked,” said senior study author Thomas Carey, PhD, professor of otolaryngology and pharmacology, and co-director of the head and neck oncology program at the U-M Comprehensive Cancer Center.

Researchers stated that the study suggests that current or former tobacco users may need more aggressive treatment regimens compared to patients who have never used tobacco.