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class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Larynx"> <div class="vector-toc-text"> 1.6 Larynx </div> </a> <ul id="toc-Larynx-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Trachea_and_salivary_glands" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Trachea_and_salivary_glands"> <div class="vector-toc-text"> 1.7 Trachea and salivary glands </div> </a> <ul id="toc-Trachea_and_salivary_glands-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Causes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Causes"> <div class="vector-toc-text"> 2 Causes </div> </a> <button aria-controls="toc-Causes-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Causes subsection </button> <ul id="toc-Causes-sublist" class="vector-toc-list"> <li id="toc-Alcohol_and_tobacco" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Alcohol_and_tobacco"> <div class="vector-toc-text"> 2.1 Alcohol and tobacco </div> </a> <ul id="toc-Alcohol_and_tobacco-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diet" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Diet"> <div class="vector-toc-text"> 2.2 Diet </div> </a> <ul id="toc-Diet-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Betel_nut" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Betel_nut"> <div class="vector-toc-text"> 2.3 Betel nut </div> </a> <ul id="toc-Betel_nut-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genetics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genetics"> <div class="vector-toc-text"> 2.4 Genetics </div> </a> <ul id="toc-Genetics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Radiation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Radiation"> <div class="vector-toc-text"> 2.5 Radiation </div> </a> <ul id="toc-Radiation-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Infection"> <div class="vector-toc-text"> 2.6 Infection </div> </a> <ul id="toc-Infection-sublist" class="vector-toc-list"> <li id="toc-Human_papillomavirus" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Human_papillomavirus"> <div class="vector-toc-text"> 2.6.1 Human papillomavirus </div> </a> <ul id="toc-Human_papillomavirus-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epstein–Barr_virus" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Epstein–Barr_virus"> <div class="vector-toc-text"> 2.6.2 Epstein–Barr virus </div> </a> <ul id="toc-Epstein–Barr_virus-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Gastroesophageal_reflux_disease" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gastroesophageal_reflux_disease"> <div class="vector-toc-text"> 2.7 Gastroesophageal reflux disease </div> </a> <ul id="toc-Gastroesophageal_reflux_disease-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hematopoietic_stem_cell_transplantation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hematopoietic_stem_cell_transplantation"> <div class="vector-toc-text"> 2.8 Hematopoietic stem cell transplantation </div> </a> <ul id="toc-Hematopoietic_stem_cell_transplantation-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_risk_factors" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_risk_factors"> <div class="vector-toc-text"> 2.9 Other risk factors </div> </a> <ul id="toc-Other_risk_factors-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 3 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Histopathology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Histopathology"> <div class="vector-toc-text"> 3.1 Histopathology </div> </a> <ul id="toc-Histopathology-sublist" class="vector-toc-list"> <li id="toc-Squamous-cell_carcinoma" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Squamous-cell_carcinoma"> <div class="vector-toc-text"> 3.1.1 Squamous-cell carcinoma </div> </a> <ul id="toc-Squamous-cell_carcinoma-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Adenocarcinoma" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Adenocarcinoma"> <div class="vector-toc-text"> 3.1.2 Adenocarcinoma </div> </a> <ul id="toc-Adenocarcinoma-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> 4 Prevention </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 5 Management </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Management subsection </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> 5.1 Surgery </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Radiation_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Radiation_therapy"> <div class="vector-toc-text"> 5.2 Radiation therapy </div> </a> <ul id="toc-Radiation_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Chemotherapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Chemotherapy"> <div class="vector-toc-text"> 5.3 Chemotherapy </div> </a> <ul id="toc-Chemotherapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Photodynamic_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Photodynamic_therapy"> <div class="vector-toc-text"> 5.4 Photodynamic therapy </div> </a> <ul id="toc-Photodynamic_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Targeted_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Targeted_therapy"> <div class="vector-toc-text"> 5.5 Targeted therapy </div> </a> <ul id="toc-Targeted_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Immunotherapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Immunotherapy"> <div class="vector-toc-text"> 5.6 Immunotherapy </div> </a> <ul id="toc-Immunotherapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment_side_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Treatment_side_effects"> <div class="vector-toc-text"> 5.7 Treatment side effects </div> </a> <ul id="toc-Treatment_side_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Psychosocial" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Psychosocial"> <div class="vector-toc-text"> 5.8 Psychosocial </div> </a> <ul id="toc-Psychosocial-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> 6 Prognosis </div> </a> <button aria-controls="toc-Prognosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prognosis subsection </button> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> <li id="toc-Problem_of_second_primaries" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Problem_of_second_primaries"> <div class="vector-toc-text"> 6.1 Problem of second primaries </div> </a> <ul id="toc-Problem_of_second_primaries-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Digestive_system" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Digestive_system"> <div class="vector-toc-text"> 6.2 Digestive system </div> </a> <ul id="toc-Digestive_system-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mental_health" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mental_health"> <div class="vector-toc-text"> 6.3 Mental health </div> </a> <ul id="toc-Mental_health-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Others" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Others"> <div class="vector-toc-text"> 6.4 Others </div> </a> <ul id="toc-Others-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 7 Epidemiology </div> </a> <button aria-controls="toc-Epidemiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Epidemiology subsection </button> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> <li id="toc-United_States" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#United_States"> <div class="vector-toc-text"> 7.1 United States </div> </a> <ul id="toc-United_States-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> 8 Research </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 9 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 10 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Head and neck cancer</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 29 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-29" aria-hidden="true" > 29 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B3%D8%B1%D8%B7%D8%A7%D9%86_%D8%A7%D9%84%D8%B1%D8%A3%D8%B3_%D9%88%D8%A7%D9%84%D8%B9%D9%86%D9%82" title="سرطان الرأس والعنق – Arabic" lang="ar" hreflang="ar" data-title="سرطان الرأس والعنق" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/C%C3%A0ncer_de_cap_i_coll" title="Càncer de cap i coll – Catalan" lang="ca" hreflang="ca" data-title="Càncer de cap i coll" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Halskr%C3%A6ft" title="Halskræft – Danish" lang="da" hreflang="da" data-title="Halskræft" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Kopf-Hals-Karzinom" title="Kopf-Hals-Karzinom – German" lang="de" hreflang="de" data-title="Kopf-Hals-Karzinom" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/C%C3%A1ncer_de_cabeza_y_cuello" title="Cáncer de cabeza y cuello – Spanish" lang="es" hreflang="es" data-title="Cáncer de cabeza y cuello" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%D8%B1%D8%B7%D8%A7%D9%86%E2%80%8C%D9%87%D8%A7%DB%8C_%D8%B3%D8%B1_%D9%88_%DA%AF%D8%B1%D8%AF%D9%86" title="سرطان‌های سر و گردن – Persian" lang="fa" hreflang="fa" data-title="سرطان‌های سر و گردن" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Cancer_des_voies_a%C3%A9rodigestives_sup%C3%A9rieures" title="Cancer des voies aérodigestives supérieures – French" lang="fr" hreflang="fr" data-title="Cancer des voies aérodigestives supérieures" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%91%90%EA%B2%BD%EB%B6%80%EC%95%94" title="두경부암 – Korean" lang="ko" hreflang="ko" data-title="두경부암" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Ciwon_Daji_na_Kai_da_Wuya" title="Ciwon Daji na Kai da Wuya – Hausa" lang="ha" hreflang="ha" data-title="Ciwon Daji na Kai da Wuya" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target">Hausa</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B3%D5%AC%D5%AD%D5%AB_%D6%87_%D5%BA%D5%A1%D6%80%D5%A1%D5%B6%D5%B8%D6%81%D5%AB_%D5%B7%D6%80%D5%BB%D5%A1%D5%B6%D5%B6%D5%A5%D6%80%D5%AB_%D6%84%D5%A1%D5%B2%D6%81%D5%AF%D5%A5%D5%B2" title="Գլխի և պարանոցի շրջանների քաղցկեղ – Armenian" lang="hy" hreflang="hy" data-title="Գլխի և պարանոցի շրջանների քաղցկեղ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Kanker_kepala_dan_leher" title="Kanker kepala dan leher – Indonesian" lang="id" hreflang="id" data-title="Kanker kepala dan leher" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Tumori_della_testa_e_del_collo" title="Tumori della testa e del collo – Italian" lang="it" hreflang="it" data-title="Tumori della testa e del collo" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A1%D7%A8%D7%98%D7%9F_%D7%A8%D7%90%D7%A9_%D7%A6%D7%95%D7%95%D7%90%D7%A8" title="סרטן ראש צוואר – Hebrew" lang="he" hreflang="he" data-title="סרטן ראש צוואר" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Keelkanker" title="Keelkanker – Dutch" lang="nl" hreflang="nl" data-title="Keelkanker" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E9%A0%AD%E9%A0%B8%E9%83%A8%E7%99%8C" title="頭頸部癌 – Japanese" lang="ja" hreflang="ja" data-title="頭頸部癌" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Hode-_og_hals-kreft" title="Hode- og hals-kreft – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Hode- og hals-kreft" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%AE%E0%AD%81%E0%AC%A3%E0%AD%8D%E0%AC%A1_%E0%AC%93_%E0%AC%AC%E0%AD%87%E0%AC%95_%E0%AC%95%E0%AC%B0%E0%AD%8D%E0%AC%95%E0%AC%9F" title="ମୁଣ୍ଡ ଓ ବେକ କର୍କଟ – Odia" lang="or" hreflang="or" data-title="ମୁଣ୍ଡ ଓ ବେକ କର୍କଟ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%B8%E0%A8%BF%E0%A8%B0_%E0%A8%85%E0%A8%A4%E0%A9%87_%E0%A8%97%E0%A8%B0%E0%A8%A6%E0%A8%A8_%E0%A8%A6%E0%A8%BE_%E0%A8%95%E0%A9%88%E0%A8%82%E0%A8%B8%E0%A8%B0" title="ਸਿਰ ਅਤੇ ਗਰਦਨ ਦਾ ਕੈਂਸਰ – Punjabi" lang="pa" hreflang="pa" data-title="ਸਿਰ ਅਤੇ ਗਰਦਨ ਦਾ ਕੈਂਸਰ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target">ਪੰਜਾਬੀ</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Nowotwory_g%C5%82owy_i_szyi" title="Nowotwory głowy i szyi – Polish" lang="pl" hreflang="pl" data-title="Nowotwory głowy i szyi" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/C%C3%A2ncer_de_cabe%C3%A7a_e_pesco%C3%A7o" title="Câncer de cabeça e pescoço – Portuguese" lang="pt" hreflang="pt" data-title="Câncer de cabeça e pescoço" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a 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from <a href="/w/index.php?title=Squamous_cell_carcinomas_of_the_head_and_neck&redirect=no" class="mw-redirect" title="Squamous cell carcinomas of the head and neck">Squamous cell carcinomas of the head and neck</a>)</div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Cancer arises in the head or neck region</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Head and neck cancer</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">head and neck squamous cell carcinoma</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><a href="/wiki/File:Diagram_showing_the_parts_of_the_pharynx_CRUK_334.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bf/Diagram_showing_the_parts_of_the_pharynx_CRUK_334.svg/220px-Diagram_showing_the_parts_of_the_pharynx_CRUK_334.svg.png" decoding="async" width="220" height="208" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bf/Diagram_showing_the_parts_of_the_pharynx_CRUK_334.svg/330px-Diagram_showing_the_parts_of_the_pharynx_CRUK_334.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bf/Diagram_showing_the_parts_of_the_pharynx_CRUK_334.svg/440px-Diagram_showing_the_parts_of_the_pharynx_CRUK_334.svg.png 2x" data-file-width="375" data-file-height="355" /></a></td></tr><tr><td colspan="2" class="infobox-full-data">Parts of the head and neck that can be affected by cancer.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Oncology" title="Oncology">Oncology</a>, <a href="/wiki/Oral_and_maxillofacial_surgery" title="Oral and maxillofacial surgery">oral and maxillofacial surgery</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">Alcohol</a>, <a href="/wiki/Tobacco" title="Tobacco">tobacco</a>, <a href="/wiki/Betel_nut_chewing" title="Betel nut chewing">betel quid</a>, <a href="/wiki/Human_papillomavirus_infection" title="Human papillomavirus infection">human papillomavirus</a>, <a href="/wiki/Radiation_exposure" title="Radiation exposure">radiation exposure</a>, certain workplace exposures, <a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a><a href="#cite_note-NCI-1">[1]</a><a href="#cite_note-WCR2014-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data"><a href="/wiki/Tissue_biopsy" class="mw-redirect" title="Tissue biopsy">Tissue biopsy</a><a href="#cite_note-NCI-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data">Not using tobacco or alcohol<a href="#cite_note-WCR2014-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Surgery, <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, <a href="/wiki/Targeted_therapy" title="Targeted therapy">targeted therapy</a><a href="#cite_note-NCI-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">5.5 million (affected during 2015)<a href="#cite_note-GBD2015Pre-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">379,000 (2015)<a href="#cite_note-GBD2015De-4">[4]</a></td></tr></tbody></table> Head and neck cancer is a general term encompassing multiple <a href="/wiki/Cancer" title="Cancer">cancers</a> that can develop in the head and neck region. These include cancers of the mouth, tongue, gums and lips (<a href="/wiki/Oral_cancer" title="Oral cancer">oral cancer</a>), voice box (<a href="/wiki/Laryngeal_cancer" title="Laryngeal cancer">laryngeal</a>), throat (<a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">nasopharyngeal</a>, <a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">oropharyngeal</a>,<a href="#cite_note-NCI-1">[1]</a> <a href="/wiki/Hypopharyngeal_cancer" title="Hypopharyngeal cancer">hypopharyngeal</a>), <a href="/wiki/Salivary_gland_tumour" title="Salivary gland tumour">salivary glands</a>, <a href="/wiki/Paranasal_sinus_and_nasal_cavity_cancer" title="Paranasal sinus and nasal cavity cancer">nose and sinuses</a>.<a href="#cite_note-Aupérin_178–186-5">[5]</a> Head and neck cancer can present a wide range of symptoms depending on where the cancer developed. These can include an <a href="/wiki/Mouth_ulcer" title="Mouth ulcer">ulcer in the mouth</a> that does not heal, <a href="/wiki/Hoarse_voice" title="Hoarse voice">changes in the voice</a>, <a href="/wiki/Dysphagia" title="Dysphagia">difficulty swallowing</a>, <a href="/wiki/Leukoplakia" title="Leukoplakia">red or white patches in the mouth</a>, and a <a href="/wiki/Neck_mass" title="Neck mass">neck lump</a>.<a href="#cite_note-:11-6">[6]</a><a href="#cite_note-7">[7]</a> The majority of head and neck cancer is caused by the use of <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">alcohol</a> or <a href="/wiki/Tobacco" title="Tobacco">tobacco</a> (including <a href="/wiki/Smokeless_tobacco" title="Smokeless tobacco">smokeless tobacco</a>). An increasing number of cases are caused by the <a href="/wiki/Human_papillomavirus_infection" title="Human papillomavirus infection">human papillomavirus</a> (HPV).<a href="#cite_note-NCIfact-8">[8]</a><a href="#cite_note-WCR2014-2">[2]</a> Other risk factors include the <a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a>, chewing <a href="/wiki/Betel_nut_chewing" title="Betel nut chewing">betel quid</a> (paan), <a href="/wiki/Radiation_exposure" title="Radiation exposure">radiation exposure</a>, poor nutrition and workplace exposure to certain toxic substances.<a href="#cite_note-NCIfact-8">[8]</a> About 90% are pathologically classified as <a href="/wiki/Squamous-cell_carcinoma" title="Squamous-cell carcinoma">squamous cell cancers</a>.<a href="#cite_note-Vug2015-9">[9]</a><a href="#cite_note-WCR2014-2">[2]</a> The diagnosis is confirmed by a <a href="/wiki/Biopsy" title="Biopsy">tissue biopsy</a>.<a href="#cite_note-NCIfact-8">[8]</a> The degree of surrounding tissue invasion and distant spread may be determined by <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a> and <a href="/wiki/Blood_test" title="Blood test">blood tests</a>.<a href="#cite_note-NCIfact-8">[8]</a> Not using tobacco or alcohol can reduce the risk of head and neck cancer.<a href="#cite_note-WCR2014-2">[2]</a> Regular dental examinations may help to identify signs before the cancer develops.<a href="#cite_note-NCI-1">[1]</a> The <a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccine</a> helps to prevent <a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-related oropharyngeal cancer</a>.<a href="#cite_note-:13-10">[10]</a> Treatment may include a combination of surgery, <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, and <a href="/wiki/Targeted_therapy" title="Targeted therapy">targeted therapy</a>.<a href="#cite_note-NCIfact-8">[8]</a> In the early stage head and neck cancers are often curable but 50% of people see their doctor when they already have an advanced disease.<a href="#cite_note-:14-11">[11]</a> Globally, head and neck cancer accounts for 650,000 new cases of cancer and 330,000 deaths annually on average. In 2018, it was the seventh most common cancer worldwide, with 890,000 new cases documented and 450,000 people dying from the disease.<a href="#cite_note-:3-12">[12]</a> The usual age at diagnosis is between 55 and 65 years old.<a href="#cite_note-SEER2016-13">[13]</a> The average <a href="/wiki/Five-year_survival_rate" title="Five-year survival rate">5-year survival</a> following diagnosis in the <a href="/wiki/Developed_country" title="Developed country">developed world</a> is 42–64%.<a href="#cite_note-SEER2016-13">[13]</a><a href="#cite_note-14">[14]</a><style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=1" title="Edit section: Signs and symptoms">edit</a>]</div> Head and neck cancers can cause a broad range of symptoms, many of which occur together. These can be categorised local (head and neck cancer-specific), general and <a href="/wiki/Gastrointestinal_tract" title="Gastrointestinal tract">gastrointestinal</a> symptoms. Local symptoms include changes in taste and voice, inflammation of the mouth or throat (<a href="/wiki/Mucositis" title="Mucositis">mucositis</a>), dry mouth (<a href="/wiki/Xerostomia" title="Xerostomia">xerostomia</a>), and difficulty swallowing (<a href="/wiki/Dysphagia" title="Dysphagia">dysphagia</a>). General symptoms include difficulty sleeping, tiredness, depression, nerve damage (<a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">peripheral neuropathy</a>). Gastrointestinal symptoms are typically nausea and vomiting.<a href="#cite_note-:11-6">[6]</a> Symptoms predominantly include a sore on the face or oral cavity that does not heal, trouble swallowing, or a change in voice. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity.<a href="#cite_note-15">[15]</a> Head and neck cancer often begins with benign signs and symptoms of the disease, like an enlarged <a href="/wiki/Lymph_node" title="Lymph node">lymph node</a> on the outside of the neck, a <a href="/wiki/Hoarse_voice" title="Hoarse voice">hoarse-sounding voice</a>, or a progressive worsening cough or sore throat. In the case of head and neck cancer, these symptoms will be notably persistent and become chronic. There may be a lump or a sore in the throat or neck that does not heal or go away. There may be difficulty or pain in swallowing. Speaking may become difficult. There may also be a persistent <a href="/wiki/Ear_pain" title="Ear pain">earache</a>.<a href="#cite_note-16">[16]</a> Other symptoms can include: a lump in the lip, mouth, or gums; ulcers or mouth sores that do not heal; bleeding from the mouth or numbness; bad breath; discolored patches that persist in the mouth; a sore tongue; and slurring of speech if the cancer is affecting the tongue. There may also be congested sinuses, weight loss, and some numbness or paralysis of <a href="/wiki/Facial_muscles" title="Facial muscles">facial muscles</a>.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Mouth">Mouth</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=2" title="Edit section: Mouth">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Oral_cancer" title="Oral cancer">Oral cancer</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Oral_cancer_(1)_squamous_cell_carcinoma_histopathology.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5e/Oral_cancer_%281%29_squamous_cell_carcinoma_histopathology.jpg/220px-Oral_cancer_%281%29_squamous_cell_carcinoma_histopathology.jpg" decoding="async" width="220" height="166" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5e/Oral_cancer_%281%29_squamous_cell_carcinoma_histopathology.jpg/330px-Oral_cancer_%281%29_squamous_cell_carcinoma_histopathology.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5e/Oral_cancer_%281%29_squamous_cell_carcinoma_histopathology.jpg/440px-Oral_cancer_%281%29_squamous_cell_carcinoma_histopathology.jpg 2x" data-file-width="2040" data-file-height="1536" /></a><figcaption>Squamous cell carcinoma of the mouth</figcaption></figure> Oral cancer affects the areas of the mouth, including the inner lip, <a href="/wiki/Tongue" title="Tongue">tongue</a>, <a href="/wiki/Floor_of_the_mouth" class="mw-redirect" title="Floor of the mouth">floor of the mouth</a>, <a href="/wiki/Gums" title="Gums">gums</a>, and <a href="/wiki/Hard_palate" title="Hard palate">hard palate</a>. Cancers of the mouth are strongly associated with <a href="/wiki/Tobacco" title="Tobacco">tobacco</a> use, especially the use of <a href="/wiki/Chewing_tobacco" title="Chewing tobacco">chewing tobacco</a> or <a href="/wiki/Dipping_tobacco" title="Dipping tobacco">dipping tobacco</a>, as well as heavy <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">alcohol</a> use. Cancers of this region, particularly the tongue, are more frequently treated with <a href="/wiki/Surgery" title="Surgery">surgery</a> than other head and neck cancers. Lip and oral cavity cancers are the most commonly encountered types of head and neck cancer.<a href="#cite_note-Aupérin_178–186-5">[5]</a> Surgeries for oral cancers include:[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <ul><li>Maxillectomy (can be done with or without <a href="/wiki/Orbital_exenteration" class="mw-redirect" title="Orbital exenteration">orbital exenteration</a>)</li> <li>Mandibulectomy (removal of the lower jaw or part of it)</li> <li><a href="/wiki/Glossectomy" title="Glossectomy">Glossectomy</a> (tongue removal; can be total, hemi, or partial)</li> <li>Radical <a href="/wiki/Neck_dissection" title="Neck dissection">neck dissection</a></li> <li>Combinational (e.g., glossectomy and <a href="/wiki/Laryngectomy" title="Laryngectomy">laryngectomy</a> done together).</li></ul> The defect is typically covered or improved by using another part of the body and/or skin grafts and/or wearing a <a href="/wiki/Prosthesis" title="Prosthesis">prosthesis</a>.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Nose">Nose</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=3" title="Edit section: Nose">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Paranasal_sinus_and_nasal_cavity_cancer" title="Paranasal sinus and nasal cavity cancer">Paranasal sinus and nasal cavity cancer</a> and <a href="/wiki/Sinonasal_undifferentiated_carcinoma" title="Sinonasal undifferentiated carcinoma">Sinonasal undifferentiated carcinoma</a></div> <a href="/wiki/Paranasal_sinus_and_nasal_cavity_cancer" title="Paranasal sinus and nasal cavity cancer">Paranasal sinus and nasal cavity cancer</a> affects the <a href="/wiki/Nasal_cavity" title="Nasal cavity">nasal cavity</a> and the <a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">paranasal sinuses</a>. Most of these cancers are <a href="/wiki/Squamous-cell_carcinoma" title="Squamous-cell carcinoma">squamous cell carcinomas</a>.<a href="#cite_note-NCI19-17">[17]</a> <div class="mw-heading mw-heading3"><h3 id="Nasopharynx">Nasopharynx</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=4" title="Edit section: Nasopharynx">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Nasopharynx_cancer" class="mw-redirect" title="Nasopharynx cancer">Nasopharynx cancer</a></div> Nasopharyngeal cancer arises in the <a href="/wiki/Nasopharynx" class="mw-redirect" title="Nasopharynx">nasopharynx</a>, the region in which the <a href="/wiki/Nasal_cavity" title="Nasal cavity">nasal cavities</a> and the <a href="/wiki/Eustachian_tube" title="Eustachian tube">Eustachian tubes</a> connect with the upper part of the throat. While some nasopharyngeal cancers are biologically similar to the common head and neck cancers, "poorly differentiated" nasopharyngeal carcinoma is <a href="/wiki/Lymphoepithelioma" title="Lymphoepithelioma">lymphoepithelioma</a>, which is distinct in its <a href="/wiki/Epidemiology" title="Epidemiology">epidemiology</a>, biology, clinical behavior, and treatment and is treated as a separate disease by many experts.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Throat">Throat</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=5" title="Edit section: Throat">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">Oropharyngeal cancer</a> and <a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-positive oropharyngeal cancer</a></div> Most <a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">oropharyngeal cancers</a> begin in the <a href="/wiki/Oropharynx" class="mw-redirect" title="Oropharynx">oropharynx</a> (throat), the middle part of the throat that includes the <a href="/wiki/Soft_palate" title="Soft palate">soft palate</a>, the base of the <a href="/wiki/Tongue" title="Tongue">tongue</a>, and the <a href="/wiki/Tonsil" title="Tonsil">tonsils</a>.<a href="#cite_note-NCI-1">[1]</a> Cancers of the tonsils are more strongly associated with <a href="/wiki/Human_papillomavirus" class="mw-redirect" title="Human papillomavirus">human papillomavirus</a> infection than are cancers of other regions of the head and neck. <a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-positive oropharyngeal cancer</a> generally has a better outcome than HPV-negative disease, with a 54% better survival rate,<a href="#cite_note-18">[18]</a> but this advantage for HPV-associated cancer applies only to oropharyngeal cancers.<a href="#cite_note-19">[19]</a> People with oropharyngeal carcinomas are at high risk of developing a second primary head and neck cancer.<a href="#cite_note-20">[20]</a> <div class="mw-heading mw-heading3"><h3 id="Hypopharynx">Hypopharynx</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=6" title="Edit section: Hypopharynx">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Hypopharyngeal_cancer" title="Hypopharyngeal cancer">Hypopharyngeal cancer</a></div> The <a href="/wiki/Hypopharynx" class="mw-redirect" title="Hypopharynx">hypopharynx</a> includes the pyriform sinuses, the posterior pharyngeal wall, and the postcricoid area. Tumors of the hypopharynx frequently have an advanced stage at diagnosis and have the most adverse prognoses of pharyngeal tumors. They tend to <a href="/wiki/Metastasis" title="Metastasis">metastasize</a> early due to the extensive lymphatic network around the <a href="/wiki/Larynx" title="Larynx">larynx</a>.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Larynx">Larynx</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=7" title="Edit section: Larynx">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Laryngeal_cancer" title="Laryngeal cancer">Laryngeal cancer</a></div> Laryngeal cancer begins in the <a href="/wiki/Larynx" title="Larynx">larynx</a>, or "voice box", and is the second most common type of head and neck cancer encountered.<a href="#cite_note-Aupérin_178–186-5">[5]</a> Cancer may occur on the <a href="/wiki/Vocal_folds" class="mw-redirect" title="Vocal folds">vocal folds</a> themselves ("glottic" cancer) or on tissues above and below the true cords ("supraglottic" and "subglottic" cancers, respectively). Laryngeal cancer is strongly associated with <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">tobacco smoking</a>.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Surgery can include laser excision of small vocal cord lesions, partial laryngectomy (removal of part of the larynx), or total laryngectomy (removal of the whole larynx). If the whole larynx has been removed, the person is left with a permanent tracheostomy. Voice rehabilitation in such patients can be achieved in three important ways: esophageal speech, tracheoesophageal puncture, or electrolarynx. One would likely require intensive teaching, speech therapy, and/or an electronic device.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Trachea_and_salivary_glands">Trachea and salivary glands</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=8" title="Edit section: Trachea and salivary glands">edit</a>]</div> <a href="/wiki/Tracheal_tumor" title="Tracheal tumor">Cancer of the trachea</a> is a rare cancer usually classified as a <a href="/wiki/Lung_cancer" title="Lung cancer">lung cancer</a>.<a href="#cite_note-21">[21]</a> Most <a href="/wiki/Salivary_gland_tumour" title="Salivary gland tumour">tumors of the salivary glands</a> differ from the common head and neck cancers in cause, <a href="/wiki/Histopathology" title="Histopathology">histopathology</a>, clinical presentation, and therapy. Other uncommon tumors arising in the head and neck include <a href="/wiki/Teratoma" title="Teratoma">teratomas</a>, <a href="/wiki/Adenocarcinomas" class="mw-redirect" title="Adenocarcinomas">adenocarcinomas</a>, <a href="/wiki/Adenoid_cystic_carcinoma" title="Adenoid cystic carcinoma">adenoid cystic carcinomas</a>, and <a href="/wiki/Mucoepidermoid_carcinoma" title="Mucoepidermoid carcinoma">mucoepidermoid carcinomas</a>.<a href="#cite_note-ridge-22">[22]</a> Rarer still are <a href="/wiki/Melanomas" class="mw-redirect" title="Melanomas">melanomas</a> and <a href="/wiki/Lymphomas" class="mw-redirect" title="Lymphomas">lymphomas</a> of the upper aerodigestive tract.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=9" title="Edit section: Causes">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Alcohol_and_tobacco">Alcohol and tobacco</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=10" title="Edit section: Alcohol and tobacco">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">Tobacco smoking</a> and <a href="/wiki/Alcohol_and_cancer" title="Alcohol and cancer">Alcohol and cancer</a></div> <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">Alcohol</a> and <a href="/wiki/Tobacco" title="Tobacco">tobacco</a> use are major risk factors for head and neck cancer. 72% of head and neck cancer cases are caused by using both alcohol and tobacco.<a href="#cite_note-:6-23">[23]</a> This rises to 89% when looking specifically at laryngeal cancer.<a href="#cite_note-24">[24]</a> There is thought to be a dose-dependent relationship between alcohol use and development of head and neck cancer where higher rates of alcohol consumption contribute to an increased risk of developing head and neck cancer.<a href="#cite_note-25">[25]</a><a href="#cite_note-26">[26]</a> Alcohol use following a diagnosis of head and neck cancer also contributes to other negative outcomes. These include physical effects such as an increased risk of developing a second primary cancer or other malignancies,<a href="#cite_note-27">[27]</a><a href="#cite_note-28">[28]</a> cancer recurrence,<a href="#cite_note-29">[29]</a> and worse prognosis<a href="#cite_note-30">[30]</a> in addition to an increased chance of having a future <a href="/wiki/Feeding_tube" title="Feeding tube">feeding tube</a> placed and <a href="/wiki/Osteoradionecrosis" title="Osteoradionecrosis">osteoradionecrosis</a> of the jaw. Negative social factors are also increased with sustained alcohol use after diagnosis including unemployment and work disability.<a href="#cite_note-:5-31">[31]</a><a href="#cite_note-32">[32]</a> The way in which alcohol contributes to cancer development is not fully understood. It is thought to be related to permanent damage of DNA strands by a metabolite of alcohol called <a href="/wiki/Acetaldehyde" title="Acetaldehyde">acetaldehyde</a>. Other suggested mechanisms include nutritional deficiencies and genetic variations.<a href="#cite_note-:5-31">[31]</a> <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">Tobacco smoking</a> is one of the main risk factors for head and neck cancer. Cigarette smokers have a lifetime increased risk for head and neck cancer that is 5 to 25 times higher than the general population.<a href="#cite_note-33">[33]</a> The ex-smoker's risk of developing head and neck cancer begins to approach the risk in the general population 15 years after <a href="/wiki/Smoking_cessation" title="Smoking cessation">smoking cessation</a>.<a href="#cite_note-34">[34]</a> In addition, people who smoke have a worse prognosis than those who have never smoked.<a href="#cite_note-35">[35]</a> Furthermore, people who continue to smoke after diagnosis of head and neck cancer have the highest probability of dying compared to those who have never smoked.<a href="#cite_note-36">[36]</a><a href="#cite_note-37">[37]</a> This effect is seen in patients with HPV-positive head and neck cancer as well.<a href="#cite_note-38">[38]</a><a href="#cite_note-39">[39]</a><a href="#cite_note-40">[40]</a> It has also been demonstrated that <a href="/wiki/Passive_smoking" title="Passive smoking">passive smoking</a>, both at work and at home, increases the risk of head and neck cancer.<a href="#cite_note-:6-23">[23]</a> A major carcinogenic compound in <a href="/wiki/Tobacco_smoke" title="Tobacco smoke">tobacco smoke</a> is <a href="/wiki/Acrylonitrile" title="Acrylonitrile">acrylonitrile</a>.<a href="#cite_note-Cunningham-41">[41]</a> Acrylonitrile appears to indirectly cause <a href="/wiki/DNA_damage" class="mw-redirect" title="DNA damage">DNA damage</a> by increasing <a href="/wiki/Oxidative_stress" title="Oxidative stress">oxidative stress</a>, leading to increased levels of <a href="/wiki/8-oxo-2%27-deoxyguanosine" class="mw-redirect" title="8-oxo-2'-deoxyguanosine">8-oxo-2'-deoxyguanosine</a> (8-oxo-dG) and <a href="/wiki/DNA-formamidopyrimidine_glycosylase" title="DNA-formamidopyrimidine glycosylase">formamidopyrimidine</a> in DNA.<a href="#cite_note-pmid19546159-42">[42]</a> (see image). Both 8-oxo-dG and formamidopyrimidine are <a href="/wiki/Mutagen" title="Mutagen">mutagenic</a>.<a href="#cite_note-pmid16679449-43">[43]</a><a href="#cite_note-pmid23934915-44">[44]</a> <a href="/wiki/DNA_glycosylase" title="DNA glycosylase">DNA glycosylase</a> <a href="/wiki/NEIL1" title="NEIL1">NEIL1</a> prevents <a href="/wiki/Mutagenesis" title="Mutagenesis">mutagenesis</a> by 8-oxo-dG<a href="#cite_note-pmid20197241-45">[45]</a> and removes formamidopyrimidines from DNA.<a href="#cite_note-pmid20955798-46">[46]</a> <a href="/wiki/Smokeless_tobacco" title="Smokeless tobacco">Smokeless tobacco</a> (including products where tobacco is <a href="/wiki/Chewing_tobacco" title="Chewing tobacco">chewed</a>) is a cause of <a href="/wiki/Oral_cancer" title="Oral cancer">oral cancer</a>. Increased risk of oral cancer caused by smokeless tobacco is present in countries such as the United States but particularly prevalent in <a href="/wiki/Southeast_Asia" title="Southeast Asia">Southeast Asian countries</a> where the use of smokeless tobacco is common.<a href="#cite_note-Aupérin_178–186-5">[5]</a><a href="#cite_note-47">[47]</a><a href="#cite_note-:7-48">[48]</a> Smokeless tobacco is associated with a higher risk of developing head and neck cancer due to the presence of the tobacco-specific carcinogen <a href="/wiki/N-Nitrosonornicotine" title="N-Nitrosonornicotine">N'-nitrosonornicotine</a>.<a href="#cite_note-:7-48">[48]</a> <a href="/wiki/Cigar" title="Cigar">Cigar</a> and <a href="/wiki/Pipe_smoking" title="Pipe smoking">pipe smoking</a> are also important risk factors for oral cancer.<a href="#cite_note-49">[49]</a> They have a dose dependent relationship with more consumption leading to higher chances of developing cancer.<a href="#cite_note-:6-23">[23]</a> The use of <a href="/wiki/Electronic_cigarette" title="Electronic cigarette">electronic cigarettes</a> may also lead to the development of head and neck cancers due to the substances like <a href="/wiki/Propylene_glycol" title="Propylene glycol">propylene glycol</a>, <a href="/wiki/Glycerol" title="Glycerol">glycerol</a>, <a href="/wiki/Nitrosamine" title="Nitrosamine">nitrosamines</a>, and metals contained therein, which can cause damage to the airways.<a href="#cite_note-ReferenceB-50">[50]</a><a href="#cite_note-Aupérin_178–186-5">[5]</a> Exposure to e-vapour has been shown to reduce cell viability and increase the rate of <a href="/wiki/Cell_death" title="Cell death">cell death</a> via <a href="/wiki/Apoptosis" title="Apoptosis">apoptosis</a> or <a href="/wiki/Necrosis" title="Necrosis">necrosis</a> with or without nicotine.<a href="#cite_note-51">[51]</a> This area of study requires more research, however.<a href="#cite_note-ReferenceB-50">[50]</a><a href="#cite_note-Aupérin_178–186-5">[5]</a> Similarly, additional research is needed to understand how <a href="/wiki/Cannabis_(drug)" title="Cannabis (drug)">marijuana</a> possibly promotes head and neck cancers.<a href="#cite_note-Gallagher_2024-52">[52]</a> A 2019 meta-analysis did not conclude that marijuana was associated with head and neck cancer risk.<a href="#cite_note-53">[53]</a> Yet individuals with cannabis use disorder were more likely to be diagnosed with such cancers in a large study published 2024.<a href="#cite_note-Gallagher_2024-52">[52]</a> <div class="mw-heading mw-heading3"><h3 id="Diet">Diet</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=11" title="Edit section: Diet">edit</a>]</div> Many dietary nutrients are associated with cancer protection and its development. Generally, foods with a protective effect with respect to oral cancer demonstrate <a href="/wiki/Antioxidant" title="Antioxidant">antioxidant</a> and <a href="/wiki/Anti-inflammatory" title="Anti-inflammatory">anti-inflammatory effects</a> such as fruits, vegetables, <a href="/wiki/Curcumin" title="Curcumin">curcumin</a> and <a href="/wiki/Green_tea" title="Green tea">green tea</a>. Conversely, pro-inflammatory food substances such as <a href="/wiki/Red_meat" title="Red meat">red meat</a>, <a href="/wiki/Processed_meat" title="Processed meat">processed meat</a> and fried food can increase the risk of developing head and neck cancer.<a href="#cite_note-:6-23">[23]</a><a href="#cite_note-54">[54]</a> An increased adherence to the <a href="/wiki/Mediterranean_diet" title="Mediterranean diet">Mediterranean diet</a> is also related to a lower risk of cancer mortality and a reduced risk of developing multiple cancers including head and neck cancer.<a href="#cite_note-55">[55]</a> Elevated levels of <a href="/wiki/Nitrite" title="Nitrite">nitrites</a> in preserved meats and <a href="/wiki/Salted_fish" title="Salted fish">salted fish</a> have been shown to increase the risk of nasopharyngeal cancer.<a href="#cite_note-:8-56">[56]</a><a href="#cite_note-57">[57]</a> Overall, a poor nutritional intake (often associated with alcoholism) with subsequent <a href="/wiki/Vitamin_deficiency" title="Vitamin deficiency">vitamin deficiencies</a> is a risk factor for head and neck cancer.<a href="#cite_note-:8-56">[56]</a><a href="#cite_note-ridge-22">[22]</a> In terms of nutritional supplements, antioxidants such as <a href="/wiki/Vitamin_E" title="Vitamin E">vitamin E</a> and <a href="/wiki/%CE%92-Carotene" title="Β-Carotene">beta-carotene</a> might reduce the toxic effect of radiotherapy in people with head and neck cancer but they can also increase recurrence rates, especially in smokers.<a href="#cite_note-58">[58]</a> <div class="mw-heading mw-heading3"><h3 id="Betel_nut">Betel nut</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=12" title="Edit section: Betel nut">edit</a>]</div> <a href="/wiki/Betel_nut_chewing" title="Betel nut chewing">Betel nut chewing</a> is associated with an increased risk of head and neck cancer.<a href="#cite_note-NCI-1">[1]</a><a href="#cite_note-59">[59]</a> When chewed with additional tobacco in its preparation (like in <a href="/wiki/Gutka" title="Gutka">gutka</a>), there is an even higher risk, especially for oral and oropharyngeal cancers.<a href="#cite_note-:6-23">[23]</a> <div class="mw-heading mw-heading3"><h3 id="Genetics">Genetics</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=13" title="Edit section: Genetics">edit</a>]</div> People who develop head and neck cancer may have a <a href="/wiki/Genetic_predisposition" title="Genetic predisposition">genetic predisposition</a> for the condition. There are seven known genetic variations (<a href="/wiki/Locus_(genetics)" title="Locus (genetics)">loci</a>) which specifically increase the chances of developing oral and pharyngeal cancer.<a href="#cite_note-60">[60]</a><a href="#cite_note-61">[61]</a> Family history, that is having a first-degree relative with head and neck cancer, is also a risk factor. In addition, genetic variations in pathways involved in <a href="/wiki/Ethanol_metabolism" class="mw-redirect" title="Ethanol metabolism">alcohol metabolism</a> (for example <a href="/wiki/Alcohol_dehydrogenase" title="Alcohol dehydrogenase">alcohol dehydrogenase</a>) have been associated with an increased head and neck cancer risk.<a href="#cite_note-:6-23">[23]</a> <div class="mw-heading mw-heading3"><h3 id="Radiation">Radiation</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=14" title="Edit section: Radiation">edit</a>]</div> It is known that prior exposure to <a href="/wiki/Ionizing_radiation" title="Ionizing radiation">radiation</a> of the head and neck is associated with an increased risk of cancer, particularly thyroid, salivary gland and squamous cell carcinomas, although there is a time-delay of many years and the overall risk is still low.<a href="#cite_note-:8-56">[56]</a> <div class="mw-heading mw-heading3"><h3 id="Infection">Infection</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=15" title="Edit section: Infection">edit</a>]</div> <div class="mw-heading mw-heading4"><h4 id="Human_papillomavirus">Human papillomavirus</h4>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=16" title="Edit section: Human papillomavirus">edit</a>]</div> Some head and neck cancers, and in particular oropharyngeal cancer, are caused by the <a href="/wiki/Human_papillomavirus" class="mw-redirect" title="Human papillomavirus">human papillomavirus</a> (HPV),<a href="#cite_note-NCI-1">[1]</a><a href="#cite_note-:9-62">[62]</a> and 70% of all head and neck cancer cases are related to HPV.<a href="#cite_note-:9-62">[62]</a> Risk factors for HPV-positive oropharyngeal cancer include multiple sexual partners, anal and oral sex and a weak immune system.<a href="#cite_note-:8-56">[56]</a> The incidence of HPV-related head and neck cancer is increasing, especially in the Western world. In the United States, the incidence of <a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-positive oropharyngeal cancer</a> has overtaken HPV-positive <a href="/wiki/Cervical_cancer" title="Cervical cancer">cervical cancer</a> as the leading HPV related cancer type.<a href="#cite_note-63">[63]</a> An increased incidence has particularly affected males. As a result, recent changes have resulted in the <a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccine</a> being offered to adolescent boys between 12-13 (previously only offered to girls between this age due to cervical cancer risks) and men under 45 <a href="/wiki/Men_who_have_sex_with_men" title="Men who have sex with men">who have sex with men</a> in the UK.<a href="#cite_note-64">[64]</a><a href="#cite_note-65">[65]</a> Over 20 different high-risk HPV subtypes have been implicated in causing head and neck cancer. In particular, HPV-16 is responsible for up to 90% of oropharyngeal cancer in North America.<a href="#cite_note-:8-56">[56]</a> Approximately 15–25% of head and neck cancers contain genomic DNA from HPV,<a href="#cite_note-66">[66]</a> and the association varies based on the site of the tumor.<a href="#cite_note-Andrew_W_2012-67">[67]</a> In the case of <a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-positive oropharyngeal cancer</a>, the highest distribution is in the <a href="/wiki/Tonsils" class="mw-redirect" title="Tonsils">tonsils</a>, where HPV DNA is found in 45–67% of the cases,<a href="#cite_note-68">[68]</a> and it is less often in the hypopharynx (13–25%), and least often in the oral cavity (12–18%) and larynx (3–7%).<a href="#cite_note-69">[69]</a><a href="#cite_note-70">[70]</a> Positive HPV16 status is associated with a improved prognosis over HPV-negative oropharyngeal cancer due to better response to <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiotherapy</a> and <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>.<a href="#cite_note-:10-71">[71]</a> HPV can induce tumors by several mechanisms:<a href="#cite_note-:10-71">[71]</a><a href="#cite_note-72">[72]</a> <ol><li>E6 and E7 oncogenic proteins.</li> <li>Disruption of <a href="/wiki/Tumor_suppressor_gene" title="Tumor suppressor gene">tumor suppressor genes</a>.</li> <li>High-level DNA amplifications, for example, <a href="/wiki/Oncogene" title="Oncogene">oncogenes</a>.</li> <li>Generating alternative nonfunctional transcripts.</li> <li>Interchromosomal rearrangements.</li> <li>Distinct host genome methylation and expression patterns, produced even when the virus is not integrated into the host genome.</li></ol> There are observed biological differences between HPV-positive and HPV-negative head and neck cancer, for example in terms of <a href="/wiki/Mutation" title="Mutation">mutation</a> patterns. In HPV-negative disease, genes frequently mutated include <a href="/wiki/P53" title="P53">TP53</a>, <a href="/wiki/CDKN2A" title="CDKN2A">CDKN2A</a> and <a href="/wiki/P110%CE%B1" title="P110α">PIK3CA</a>.<a href="#cite_note-73">[73]</a> In HPV-positive disease, these genes are less frequently mutated, and the tumour suppressor gene p53 and <a href="/wiki/Retinoblastoma_protein" title="Retinoblastoma protein">pRb</a> (protein retinoblastoma) are commonly inactivated by HPV oncoproteins E6 and E7 respectively.<a href="#cite_note-74">[74]</a> In addition, viral infections such as HPV can cause aberrant <a href="/wiki/DNA_methylation" title="DNA methylation">DNA methylation</a> during cancer development. HPV-positive head and neck cancers demonstrate higher levels of such DNA methylation compared to HPV-negative disease.<a href="#cite_note-75">[75]</a> E6 sequesters p53 to promote p53 degradation, while E7 inhibits pRb. Degradation of p53 results in cells being unable to respond to checkpoint signals that are normally present to activate <a href="/wiki/Apoptosis" title="Apoptosis">apoptosis</a> when DNA damage is signalled. Loss of pRb leads to deregulation of <a href="/wiki/Cell_proliferation" title="Cell proliferation">cell proliferation</a> and apoptosis. Both mechanisms therefore leave cell proliferation unchecked and increase the chance of <a href="/wiki/Carcinogenesis" title="Carcinogenesis">carcinogenesis</a>.<a href="#cite_note-76">[76]</a> <div class="mw-heading mw-heading4"><h4 id="Epstein–Barr_virus">Epstein–Barr virus</h4>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=17" title="Edit section: Epstein–Barr virus">edit</a>]</div> <a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a> (EBV) infection is associated with <a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">nasopharyngeal cancer</a>. Nasopharyngeal cancer caused by EBV commonly occurs in some countries of the Mediterranean and Asia, where EBV <a href="/wiki/Antibody_titer" class="mw-redirect" title="Antibody titer">antibody titers</a> can be measured to screen high-risk populations.<a href="#cite_note-77">[77]</a><a href="#cite_note-78">[78]</a> <div class="mw-heading mw-heading3"><h3 id="Gastroesophageal_reflux_disease">Gastroesophageal reflux disease</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=18" title="Edit section: Gastroesophageal reflux disease">edit</a>]</div> The presence of <a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastroesophageal reflux disease</a> (GERD) or laryngeal reflux disease can also be a major factor. <a href="/wiki/Stomach_acid" class="mw-redirect" title="Stomach acid">Stomach acids</a> that flow up through the <a href="/wiki/Esophagus" title="Esophagus">esophagus</a> can damage its lining and raise susceptibility to throat cancer.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Hematopoietic_stem_cell_transplantation">Hematopoietic stem cell transplantation</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=19" title="Edit section: Hematopoietic stem cell transplantation">edit</a>]</div> People after <a href="/wiki/Hematopoietic_stem_cell_transplantation" title="Hematopoietic stem cell transplantation">hematopoietic stem cell transplantation</a> (HSCT) are at a higher risk for oral cancer. Post-HSCT oral cancer may have more aggressive behavior and a poorer prognosis when compared to oral cancer in non-HSCT patients.<a href="#cite_note-HSCT-79">[79]</a> This effect is supposed to be due to continuous, lifelong <a href="/wiki/Immune_system" title="Immune system">immune</a> suppression and chronic oral <a href="/wiki/Graft-versus-host_disease" title="Graft-versus-host disease">graft-versus-host disease</a>.<a href="#cite_note-HSCT-79">[79]</a> <div class="mw-heading mw-heading3"><h3 id="Other_risk_factors">Other risk factors</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=20" title="Edit section: Other risk factors">edit</a>]</div> Several other risk factors have been identified in the development of head and neck cancer. These include occupational environmental <a href="/wiki/Carcinogen" title="Carcinogen">carcinogen</a> exposure such as <a href="/wiki/Asbestos" title="Asbestos">asbestos</a>, <a href="/wiki/Sawdust" title="Sawdust">wood dust</a>, <a href="/wiki/Mineral_acid" title="Mineral acid">mineral acid</a>, <a href="/wiki/Sulfuric_acid" title="Sulfuric acid">sulfuric acid mists</a> and metal dusts. In addition, weakened immune systems, age greater than 55 years, poor <a href="/wiki/Socioeconomic_status" title="Socioeconomic status">socioeconomic factors</a> such as lower incomes and occupational status, and low <a href="/wiki/Body_mass_index" title="Body mass index">body mass index</a> (<18.5 kg/m2) are also risk factors.<a href="#cite_note-:8-56">[56]</a><a href="#cite_note-80">[80]</a><a href="#cite_note-:6-23">[23]</a> Poor <a href="/wiki/Oral_hygiene" title="Oral hygiene">oral hygiene</a> and chronic <a href="/wiki/Stomatitis" title="Stomatitis">oral cavity inflammation</a> (for example secondary to <a href="/wiki/Chronic_periodontitis" title="Chronic periodontitis">chronic gum inflammation</a>) are also linked to an increased head and neck cancer risk.<a href="#cite_note-81">[81]</a><a href="#cite_note-82">[82]</a> The presence of <a href="/wiki/Leukoplakia" title="Leukoplakia">leukoplakia</a>, which is the appearance of white patches or spots in the mouth, can develop into cancer in about 1⁄3 of cases.<a href="#cite_note-ridge-22">[22]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=21" title="Edit section: Diagnosis">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1237032888/mw-parser-output/.tmulti">.mw-parser-output .tmulti .multiimageinner{display:flex;flex-direction:column}.mw-parser-output .tmulti .trow{display:flex;flex-direction:row;clear:left;flex-wrap:wrap;width:100%;box-sizing:border-box}.mw-parser-output .tmulti .tsingle{margin:1px;float:left}.mw-parser-output .tmulti .theader{clear:both;font-weight:bold;text-align:center;align-self:center;background-color:transparent;width:100%}.mw-parser-output .tmulti .thumbcaption{background-color:transparent}.mw-parser-output .tmulti .text-align-left{text-align:left}.mw-parser-output .tmulti .text-align-right{text-align:right}.mw-parser-output .tmulti .text-align-center{text-align:center}@media all and (max-width:720px){.mw-parser-output .tmulti .thumbinner{width:100%!important;box-sizing:border-box;max-width:none!important;align-items:center}.mw-parser-output .tmulti .trow{justify-content:center}.mw-parser-output .tmulti .tsingle{float:none!important;max-width:100%!important;box-sizing:border-box;text-align:center}.mw-parser-output .tmulti .tsingle .thumbcaption{text-align:left}.mw-parser-output .tmulti .trow>.thumbcaption{text-align:center}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .tmulti .multiimageinner img{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .tmulti .multiimageinner img{background-color:white}}</style><div class="thumb tmulti tright"><div class="thumbinner multiimageinner" style="width:204px;max-width:204px"><div class="trow"><div class="tsingle" style="width:202px;max-width:202px"><div class="thumbimage"><a href="/wiki/File:PET-CT_scanning_of_lymph_node_metastases_in_cancer_2.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f4/PET-CT_scanning_of_lymph_node_metastases_in_cancer_2.jpg/200px-PET-CT_scanning_of_lymph_node_metastases_in_cancer_2.jpg" decoding="async" width="200" height="129" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f4/PET-CT_scanning_of_lymph_node_metastases_in_cancer_2.jpg/300px-PET-CT_scanning_of_lymph_node_metastases_in_cancer_2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f4/PET-CT_scanning_of_lymph_node_metastases_in_cancer_2.jpg/400px-PET-CT_scanning_of_lymph_node_metastases_in_cancer_2.jpg 2x" data-file-width="510" data-file-height="328" /></a></div></div></div><div class="trow"><div class="tsingle" style="width:202px;max-width:202px"><div class="thumbimage"><a href="/wiki/File:PET-CT_scanning_of_lymph_node_metastases_in_cancer.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fe/PET-CT_scanning_of_lymph_node_metastases_in_cancer.jpg/200px-PET-CT_scanning_of_lymph_node_metastases_in_cancer.jpg" decoding="async" width="200" height="142" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fe/PET-CT_scanning_of_lymph_node_metastases_in_cancer.jpg/300px-PET-CT_scanning_of_lymph_node_metastases_in_cancer.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fe/PET-CT_scanning_of_lymph_node_metastases_in_cancer.jpg/400px-PET-CT_scanning_of_lymph_node_metastases_in_cancer.jpg 2x" data-file-width="905" data-file-height="642" /></a></div></div></div><div class="trow" style="display:flex"><div class="thumbcaption">Left inferior internal jugular node metastases with extranodal invasion, two years after <a href="/wiki/Brachytherapy" title="Brachytherapy">brachytherapy</a> for <a href="/wiki/Oral_cancer" title="Oral cancer">tongue cancer</a>. <a href="/wiki/PET-CT" title="PET-CT">PET-CT</a> scanning of a male in his 30s, 64 minutes after <a href="/wiki/Fluorodeoxyglucose_(18F)" title="Fluorodeoxyglucose (18F)">fludeoxyglucose (18F)</a> was administered, shows some fluff around the tumor.</div></div></div></div> A significant proportion of people with head and neck cancer will present to their physicians with an already advanced stage disease.<a href="#cite_note-:14-11">[11]</a> This can either be down to patient factors (delays in seeking medical attention), or physician factors (such as delays in referral from primary care, or non-diagnostic investigation results).<a href="#cite_note-83">[83]</a> A person usually presents to the physician complaining of one or more of the typical symptoms. These symptoms may be site specific (such as a laryngeal cancer causing <a href="/wiki/Hoarse_voice" title="Hoarse voice">hoarse voice</a>), or not site specific (earache can be caused by multiple types of head and neck cancers).<a href="#cite_note-:11-6">[6]</a> The physician will undertake a thorough history to determine the nature of the symptoms and the presence or absence of any risk factors. The physician will also ask about other illnesses such as heart or lung diseases as they may impact their fitness for potentially curative treatment. Clinical examination will involve examination of the neck for any masses, examining inside the mouth for any abnormalities and assessing the rest of the pharynx and larynx with a <a href="/wiki/Nasoendoscopy" title="Nasoendoscopy">nasendoscope</a>.<a href="#cite_note-84">[84]</a> Further investigations will be directed by the symptoms discussed and any abnormalities identified during the exam.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <a href="/wiki/Neck_mass" title="Neck mass">Neck masses</a> typically undergo assessment with <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a> and a <a href="/wiki/Fine-needle_aspiration" title="Fine-needle aspiration">fine-needle aspiration</a> (FNA, a type of needle biopsy). Concerning <a href="/wiki/Lesion" title="Lesion">lesions</a> that are readily accessible (such as in the mouth) can be biopsied with a <a href="/wiki/Local_anesthetic" title="Local anesthetic">local anaesthetic</a>. Lesions less readily available can be biopsied either with the patient awake or under a <a href="/wiki/General_anaesthetic" title="General anaesthetic">general anaesthetic</a> depending on local expertise and availability of specialist equipment.<a href="#cite_note-85">[85]</a> The cancer will also need to be <a href="/wiki/Cancer_staging" title="Cancer staging">staged</a> (accurately determine its size, association with nearby structures, and spread to distant sites). This is typically done by scanning the patient with a combination of <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">magnetic resonance imaging</a> (MRI), <a href="/wiki/CT_scan" title="CT scan">computed tomography</a> (CT) and/or <a href="/wiki/Positron_emission_tomography" title="Positron emission tomography">positron emission tomography</a> (PET). Exactly which investigations are required will depend on a variety of factors such as the site of concern and the size of the tumour.<a href="#cite_note-:12-86">[86]</a> Some people will present with a neck lump containing cancer cells (identified by <a href="/wiki/Fine-needle_aspiration" title="Fine-needle aspiration">FNA</a>) that have spread from elsewhere, but with no identifiable primary site on initial assessment. In such cases people will undergo additional testing to attempt to find the initial site of cancer, as this has significant implications for their treatment. These patients undergo MRI scanning, <a href="/wiki/PET-CT" title="PET-CT">PET-CT</a> and then <a href="/wiki/Endoscopy" title="Endoscopy">panendoscopy</a> and <a href="/wiki/Biopsy" title="Biopsy">biopsies</a> of any abnormal areas. If the scans and panendoscopy still do not identify a primary site for the cancer, affected people will undergo a bilateral <a href="/wiki/Tonsillectomy" title="Tonsillectomy">tonsillectomy</a> and tongue base <a href="/wiki/Mucosectomy" title="Mucosectomy">mucosectomy</a> (as these are the most common subsites of cancer that spread to the neck). This procedure can be done with or without <a href="/wiki/Robot-assisted_surgery" title="Robot-assisted surgery">robotic assistance</a>.<a href="#cite_note-87">[87]</a> Once a diagnosis is confirmed, a multidisciplinary discussion of the optimal treatment strategy will be undertaken between the <a href="/wiki/Radiation_oncologist" title="Radiation oncologist">radiation oncologist</a>, <a href="/wiki/Surgical_oncology" title="Surgical oncology">surgical oncologist</a>, and <a href="/wiki/Medical_oncology" class="mw-redirect" title="Medical oncology">medical oncologist</a>. A <a href="/wiki/Histopathology" title="Histopathology">histopathologist</a> and a <a href="/wiki/Radiology" title="Radiology">radiologist</a> will also be present to discuss the biopsy and imaging findings.<a href="#cite_note-:12-86">[86]</a> Most (90%) cancers of the head and neck are <a href="/wiki/Squamous_cell" class="mw-redirect" title="Squamous cell">squamous cell</a>-derived, termed "head-and-neck squamous-cell carcinomas".<a href="#cite_note-Vug2015-9">[9]</a> <div class="mw-heading mw-heading3"><h3 id="Histopathology">Histopathology</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=22" title="Edit section: Histopathology">edit</a>]</div> Throat cancers are classified according to their <a href="/wiki/Histology" title="Histology">histology</a> or cell structure and are commonly referred to by their location in the oral cavity and neck. This is because where the cancer appears in the throat affects the prognosis; some throat cancers are more aggressive than others, depending on their location. The stage at which the cancer is diagnosed is also a critical factor in the prognosis of throat cancer. Treatment guidelines recommend routine testing for the presence of HPV for all oropharyngeal squamous cell carcinoma tumors.<a href="#cite_note-88">[88]</a> <div class="mw-heading mw-heading4"><h4 id="Squamous-cell_carcinoma">Squamous-cell carcinoma</h4>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=23" title="Edit section: Squamous-cell carcinoma">edit</a>]</div> <a href="/wiki/Squamous-cell_carcinoma" title="Squamous-cell carcinoma">Squamous-cell carcinoma</a> is a <a href="/wiki/Cancer" title="Cancer">cancer</a> of the <a href="/wiki/Squamous_cell" class="mw-redirect" title="Squamous cell">squamous cell</a>, a kind of <a href="/wiki/Epithelial" class="mw-redirect" title="Epithelial">epithelial</a> cell found in both the <a href="/wiki/Skin" title="Skin">skin</a> and <a href="/wiki/Mucous_membrane" title="Mucous membrane">mucous membranes</a>. It accounts for over 90% of all head and neck cancers,<a href="#cite_note-Haines-2013-89">[89]</a> including more than 90% of throat cancer.<a href="#cite_note-ridge-22">[22]</a> Squamous cell carcinoma is most likely to appear in males over 40 years of age with a history of heavy alcohol use coupled with smoking.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] All squamous cell carcinomas arising from the oropharynx, and all neck node <a href="/wiki/Metastasis" title="Metastasis">metastases</a> of unknown primary should undergo testing for HPV status. This is essential to adequately stage the tumour and adequately plan treatment. Due to the different biology of HPV positive and negative cancers, differentiating HPV status is also important for ongoing research to determine the best treatments.<a href="#cite_note-90">[90]</a> <a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">Nasopharyngeal carcinomas</a>, or neck node metastases possibly arising from the nasopharynx will also be tested for Ebstein Barr virus.<a href="#cite_note-91">[91]</a> The tumor marker Cyfra 21-1 may be useful in diagnosing squamous cell carcinoma of the head and neck (SCCHN).<a href="#cite_note-92">[92]</a> <div class="mw-heading mw-heading4"><h4 id="Adenocarcinoma">Adenocarcinoma</h4>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=24" title="Edit section: Adenocarcinoma">edit</a>]</div> <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a> is a cancer of the epithelial tissue that has <a href="/wiki/Gland" title="Gland">glandular</a> characteristics. Several head and neck cancers are adenocarcinomas (either of intestinal or non-intestinal cell types).<a href="#cite_note-Haines-2013-89">[89]</a> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=25" title="Edit section: Prevention">edit</a>]</div> Avoidance of risk factors (such as smoking and alcohol) is the single most effective form of prevention.<a href="#cite_note-:8-56">[56]</a> Regular dental examinations may identify pre-cancerous lesions in the oral cavity.<a href="#cite_note-NCI-1">[1]</a> While <a href="/wiki/Cancer_screening" title="Cancer screening">screening</a> in the general population does not appear to be useful, screening high-risk groups by examination of the throat might be useful.<a href="#cite_note-WCR2014-2">[2]</a> Head and neck cancer is often curable if it is diagnosed early; however, outcomes are typically poor if it is diagnosed late.<a href="#cite_note-WCR2014-2">[2]</a> When diagnosed early, oral, head, and neck cancers can be treated more easily, and the chances of survival increase tremendously.<a href="#cite_note-NCI-1">[1]</a> The <a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccine</a> helps to prevent the development of HPV-related oropharyngeal cancer.<a href="#cite_note-:13-10">[10]</a> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=26" title="Edit section: Management">edit</a>]</div> Improvements in diagnosis and local management, as well as <a href="/wiki/Targeted_therapy" title="Targeted therapy">targeted therapy</a>, have led to improvements in quality of life and survival for people with head and neck cancer.<a href="#cite_note-93">[93]</a> After a histologic diagnosis has been established and tumor extent determined, such as with the use of PET-CT,<a href="#cite_note-94">[94]</a> the selection of appropriate treatment for a specific cancer depends on a complex array of variables, including tumor site, relative morbidity of various treatment options, concomitant health problems, social and logistic factors, previous primary tumors, and the person's preference. Treatment planning generally requires a multidisciplinary approach involving specialist surgeons, medical oncologists, and radiation oncologists. [<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Surgical resection and radiation therapy are the mainstays of treatment for most head and neck cancers and remain the standard of care in most cases. For small primary cancers without regional metastases (stage I or II), wide surgical excision alone or curative radiation therapy alone is used. For more extensive primary tumors or those with regional metastases (stage III or IV), planned combinations of pre- or postoperative radiation and complete surgical excision are generally used. More recently, as historical survival and control rates have been recognized as less than satisfactory, there has been an emphasis on the use of various induction or concomitant chemotherapy regimens.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=27" title="Edit section: Surgery">edit</a>]</div> <a href="/wiki/Surgery" title="Surgery">Surgery</a> as a treatment is frequently used for most types of head and neck cancer. Usually, the goal is to remove the cancerous cells entirely. This can be particularly tricky if the cancer is near the <a href="/wiki/Larynx" title="Larynx">larynx</a> and can result in the person being unable to speak. Surgery is also commonly used to resect (remove) some or all of the cervical lymph nodes to prevent further spread of the disease. <a href="/wiki/Transoral_robotic_surgery" title="Transoral robotic surgery">Transoral robotic surgery</a> (TORS) is gaining popularity worldwide as the technology and training become more accessible. It now has an established role in the treatment of early stage oropharyngeal cancer.<a href="#cite_note-95">[95]</a> There is also a growing trend worldwide towards TORS for the surgical treatment of laryngeal and hypopharyngeal tumours.<a href="#cite_note-96">[96]</a><a href="#cite_note-97">[97]</a> <a href="/wiki/Laser_surgery#Equipment" title="Laser surgery">CO2 laser surgery</a> is also another form of treatment. <a href="/wiki/Transoral_laser_microsurgery" title="Transoral laser microsurgery">Transoral laser microsurgery</a> allows surgeons to remove tumors from the voice box with no external incisions. It also allows access to tumors that are not reachable with robotic surgery. During the surgery, the surgeon and pathologist work together to assess the adequacy of excision ("margin status"), minimizing the amount of normal tissue removed or damaged.<a href="#cite_note-98">[98]</a> This technique helps give the person as much speech and swallowing function as possible after surgery.<a href="#cite_note-99">[99]</a> <div class="mw-heading mw-heading3"><h3 id="Radiation_therapy">Radiation therapy</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=28" title="Edit section: Radiation therapy">edit</a>]</div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Radiation-mask.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Radiation-mask.jpg/220px-Radiation-mask.jpg" decoding="async" width="220" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Radiation-mask.jpg/330px-Radiation-mask.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Radiation-mask.jpg/440px-Radiation-mask.jpg 2x" data-file-width="800" data-file-height="690" /></a><figcaption>Radiation mask used in the treatment of throat cancer</figcaption></figure> <a href="/wiki/Radiation_therapy" title="Radiation therapy">Radiation therapy</a> is the most common form of treatment. There are different forms of radiation therapy, including 3D conformal radiation therapy, intensity-modulated radiation therapy, <a href="/wiki/Proton_therapy" title="Proton therapy">particle beam therapy</a>, and brachytherapy, which are commonly used in the treatment of cancers of the head and neck. Most people with head and neck cancer who are treated in the United States and Europe are treated with intensity-modulated radiation therapy using high-energy photons. At higher doses, head and neck radiation is associated with <a href="/wiki/Thyroid" title="Thyroid">thyroid</a> dysfunction and <a href="/wiki/Pituitary_gland" title="Pituitary gland">pituitary</a> axis dysfunction.<a href="#cite_note-100">[100]</a> Radiation therapy for head and neck cancers can also cause acute skin reactions of varying severity, which can be treated and managed with topically applied creams or specialist films.<a href="#cite_note-auto-101">[101]</a> <div class="mw-heading mw-heading3"><h3 id="Chemotherapy">Chemotherapy</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=29" title="Edit section: Chemotherapy">edit</a>]</div> <a href="/wiki/Chemotherapy" title="Chemotherapy">Chemotherapy</a> for throat cancer is not generally used to cure the cancer as such. Instead, it is used to provide an inhospitable environment for metastases so that they will not establish themselves in other parts of the body. Typical chemotherapy agents are a combination of <a href="/wiki/Paclitaxel" title="Paclitaxel">paclitaxel</a> and <a href="/wiki/Carboplatin" title="Carboplatin">carboplatin</a>. <a href="/wiki/Cetuximab" title="Cetuximab">Cetuximab</a> is also used in the treatment of throat cancer.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <a href="/wiki/Docetaxel" title="Docetaxel">Docetaxel</a>-based chemotherapy has shown a very good response in locally advanced head and neck cancer. Docetaxel is the only <a href="/wiki/Taxane" title="Taxane">taxane</a> approved by the FDA for head and neck cancer, in combination with cisplatin and fluorouracil for the induction treatment of inoperable, locally advanced head and neck cancer.<a href="#cite_note-102">[102]</a> While not specifically a chemotherapy, <a href="/wiki/Amifostine" title="Amifostine">amifostine</a> is often administered <a href="/wiki/Intravenous_therapy" title="Intravenous therapy">intravenously</a> by a chemotherapy clinic prior to <a href="/wiki/Radiation_therapy#Intensity-modulated_radiation_therapy_(IMRT)" title="Radiation therapy">IMRT</a> radiotherapy sessions. Amifostine protects the gums and <a href="/wiki/Salivary_gland" title="Salivary gland">salivary glands</a> from the effects of radiation.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] There is no evidence that <a href="/wiki/Erythropoietin" title="Erythropoietin">erythropoietin</a> should be routinely given with radiotherapy.<a href="#cite_note-103">[103]</a> <div class="mw-heading mw-heading3"><h3 id="Photodynamic_therapy">Photodynamic therapy</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=30" title="Edit section: Photodynamic therapy">edit</a>]</div> <a href="/wiki/Photodynamic_therapy" title="Photodynamic therapy">Photodynamic therapy</a> may have promise for treating mucosal dysplasia and small head and neck tumors.<a href="#cite_note-ridge-22">[22]</a> <a href="/wiki/Amphinex" title="Amphinex">Amphinex</a> is showing good results in early clinical trials for the treatment of advanced head and neck cancer.<a href="#cite_note-104">[104]</a> <div class="mw-heading mw-heading3"><h3 id="Targeted_therapy">Targeted therapy</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=31" title="Edit section: Targeted therapy">edit</a>]</div> <a href="/wiki/Targeted_therapy" title="Targeted therapy">Targeted therapy</a>, according to the <a href="/wiki/National_Cancer_Institute" title="National Cancer Institute">National Cancer Institute</a>, is "a type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells without harming normal cells." Some <a href="/wiki/Targeted_therapy" title="Targeted therapy">targeted therapies</a> used in head and neck cancers include <a href="/wiki/Cetuximab" title="Cetuximab">cetuximab</a>, <a href="/wiki/Bevacizumab" title="Bevacizumab">bevacizumab</a>, and <a href="/wiki/Erlotinib" title="Erlotinib">erlotinib</a>.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <a href="/wiki/Cetuximab" title="Cetuximab">Cetuximab</a> is used for treating people with advanced-stage cancer who cannot be treated with conventional chemotherapy (<a href="/wiki/Cisplatin" title="Cisplatin">cisplatin</a>).<a href="#cite_note-105">[105]</a><a href="#cite_note-106">[106]</a> However, cetuximab's efficacy is still under investigation by researchers.<a href="#cite_note-107">[107]</a> <a href="/wiki/Gendicine" title="Gendicine">Gendicine</a> is a <a href="/wiki/Gene_therapy" title="Gene therapy">gene therapy</a> that employs an <a href="/wiki/Adenoviridae" title="Adenoviridae">adenovirus</a> to deliver the <a href="/wiki/Tumor_suppressor_gene" title="Tumor suppressor gene">tumor suppressor gene</a> <a href="/wiki/P53" title="P53">p53</a> to cells. It was approved in China in 2003 for the treatment of head and neck cancer.<a href="#cite_note-Gend-108">[108]</a> The mutational profiles of <a href="/wiki/Human_papillomavirus_infection" title="Human papillomavirus infection">HPV</a>+ and HPV- head and neck cancer have been reported, further demonstrating that they are fundamentally distinct diseases. <a href="#cite_note-109">[109]</a>[<a href="/wiki/Wikipedia:No_original_research#Primary,_secondary_and_tertiary_sources" title="Wikipedia:No original research">non-primary source needed</a>] <div class="mw-heading mw-heading3"><h3 id="Immunotherapy">Immunotherapy</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=32" title="Edit section: Immunotherapy">edit</a>]</div> <a href="/wiki/Immunotherapy" title="Immunotherapy">Immunotherapy</a> is a type of treatment that activates the immune system to fight cancer. One type of immunotherapy, immune checkpoint blockade, binds to and blocks inhibitory signals on immune cells to release their anti-cancer activities.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] In 2016, the FDA granted accelerated approval to <a href="/wiki/Pembrolizumab" title="Pembrolizumab">pembrolizumab</a> for the treatment of people with recurrent or metastatic head and neck cancer with disease progression on or after platinum-containing chemotherapy.<a href="#cite_note-110">[110]</a> Later that year, the FDA approved <a href="/wiki/Nivolumab" title="Nivolumab">nivolumab</a> for the treatment of recurrent or metastatic head and neck cancer with disease progression on or after platinum-based chemotherapy.<a href="#cite_note-111">[111]</a> In 2019, the FDA approved <a href="/wiki/Pembrolizumab" title="Pembrolizumab">pembrolizumab</a> for the first-line treatment of metastatic or unresectable recurrent head and neck cancer.<a href="#cite_note-112">[112]</a> <div class="mw-heading mw-heading3"><h3 id="Treatment_side_effects">Treatment side effects</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=33" title="Edit section: Treatment side effects">edit</a>]</div> Depending on the treatment used, people with head and neck cancer may experience the following symptoms and treatment side effects:<a href="#cite_note-ridge-22">[22]</a><a href="#cite_note-auto-101">[101]</a> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 30em;"> <ul><li>Eating problems</li> <li>Pain associated with lesions</li> <li><a href="/wiki/Mucositis" title="Mucositis">Mucositis</a></li> <li><a href="/wiki/Nephrotoxicity" title="Nephrotoxicity">Nephrotoxicity</a> and <a href="/wiki/Ototoxicity" title="Ototoxicity">ototoxicity</a></li> <li><a href="/wiki/Xerostomia" title="Xerostomia">Xerostomia</a></li> <li><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux</a></li> <li>Radiation-induced <a href="/wiki/Osteonecrosis_of_the_jaw" title="Osteonecrosis of the jaw">osteonecrosis of the jaw</a></li> <li>Radiation-induced acute skin reactions</li></ul> </div> <div class="mw-heading mw-heading3"><h3 id="Psychosocial">Psychosocial</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=34" title="Edit section: Psychosocial">edit</a>]</div> Programs to support the emotional and social well-being of people who have been diagnosed with head and neck cancer may be offered.<a href="#cite_note-:1-113">[113]</a> There is no clear evidence on the effectiveness of these interventions or any particular type of psychosocial program or length of time that is most helpful for those with head and neck cancer.<a href="#cite_note-:1-113">[113]</a> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=35" title="Edit section: Prognosis">edit</a>]</div> Although early-stage head and neck cancers (especially laryngeal and oral cavity) have high cure rates, up to 50% of people with head and neck cancer present with advanced disease.<a href="#cite_note-Gourin_C,_Podolsky_R_2006_1093–106-114">[114]</a> Cure rates decrease in locally advanced cases, whose probability of cure is inversely related to tumor size and even more so to the extent of regional node involvement. [<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] HPV-associated oropharyngeal cancer has been shown to respond better to chemoradiation and, subsequently, have a better prognosis compared to non-associated HPV head and neck cancer.<a href="#cite_note-:3-12">[12]</a> Consensus panels in America (<a href="/wiki/American_Joint_Committee_on_Cancer" title="American Joint Committee on Cancer">AJCC</a>) and Europe (<a href="/wiki/Union_for_International_Cancer_Control" title="Union for International Cancer Control">UICC</a>) have established staging systems for head and neck cancers. These staging systems attempt to standardize clinical trial criteria for research studies and define prognostic categories of disease. Head and neck cancers are staged according to the <a href="/wiki/TNM_staging_system" title="TNM staging system">TNM</a> classification system, where T is the size and configuration of the tumor, N is the presence or absence of lymph node metastases, and M is the presence or absence of distant metastases. The T, N, and M characteristics are combined to produce a "stage" of the cancer, from I to IVB.<a href="#cite_note-115">[115]</a> <div class="mw-heading mw-heading3"><h3 id="Problem_of_second_primaries">Problem of second primaries</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=36" title="Edit section: Problem of second primaries">edit</a>]</div> Survival advantages provided by new treatment modalities have been undermined by the significant percentage of people cured of head and neck cancer who subsequently develop second <a href="/wiki/Primary_tumor" title="Primary tumor">primary tumors</a>. The incidence of second primary tumors ranges in studies from 9%<a href="#cite_note-116">[116]</a> to 23%<a href="#cite_note-117">[117]</a> at 20 years. Second primary tumors are the major threat to long-term survival after successful therapy of early-stage head and neck cancer.<a href="#cite_note-priante-2011-118">[118]</a> Their high incidence results from the same carcinogenic exposure responsible for the initial primary process, called <a href="/wiki/Field_cancerization" title="Field cancerization">field cancerization</a>.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading3"><h3 id="Digestive_system">Digestive system</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=37" title="Edit section: Digestive system">edit</a>]</div> Many people with head and neck cancer are also not able to eat sufficiently. A tumor may impair a person's ability to swallow and eat, and throat cancer may affect the <a href="/wiki/Digestive_system" class="mw-redirect" title="Digestive system">digestive system</a>. The difficulty in swallowing can cause a person to <a href="/wiki/Choking" title="Choking">choke</a> on their food in the early stages of digestion and interfere with the food's smooth travel down into the <a href="/wiki/Esophagus" title="Esophagus">esophagus</a> and beyond.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] The treatments for throat cancer can also be harmful to the digestive system as well as other body systems. Radiation therapy can lead to <a href="/wiki/Nausea" title="Nausea">nausea</a> and <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, which can deprive the body of vital fluids (although these may be obtained through intravenous fluids if necessary). Frequent vomiting can lead to an electrolyte imbalance, which has serious consequences for the proper functioning of the heart. Frequent vomiting can also upset the balance of stomach acids, which has a negative impact on the digestive system, especially the lining of the stomach and esophagus.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <a href="/wiki/Enteral_feeding" class="mw-redirect" title="Enteral feeding">Enteral feeding</a>, a method that adds nutrients directly into a person's stomach using a <a href="/wiki/Nasogastric_intubation" class="mw-redirect" title="Nasogastric intubation">nasogastric</a> feeding tube or a <a href="/wiki/Gastrostomy_tube" class="mw-redirect" title="Gastrostomy tube">gastrostomy tube</a>, may be necessary for some people.<a href="#cite_note-:0-119">[119]</a> Further research is required to determine the most effective method of enteral feeding to ensure that people undergoing radiotherapy or chemoradiation treatment are able to stay nourished during their treatment.<a href="#cite_note-:0-119">[119]</a> <div class="mw-heading mw-heading3"><h3 id="Mental_health">Mental health</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=38" title="Edit section: Mental health">edit</a>]</div> Cancer in the head or neck may impact a person's mental well-being and can sometimes lead to social isolation.<a href="#cite_note-:1-113">[113]</a> This largely results from a decreased ability or inability to eat, speak, or effectively communicate. Physical appearance is often altered by the cancer itself and/or as a consequence of treatment side effects. Psychological distress may occur, and feelings such as uncertainty and fear may arise.<a href="#cite_note-:1-113">[113]</a> Some people may also have a changed physical appearance, differences in swallowing or breathing, and residual pain to manage.<a href="#cite_note-:1-113">[113]</a> Caregiver stress Caregivers for people with head and neck cancer show higher rates of <a href="/wiki/Caregiver_stress" title="Caregiver stress">caregiver stress</a> and poorer mental health compared to both the general population and those caring for non-head and neck cancer patients.<a href="#cite_note-120">[120]</a> The high symptom burden patients' experience necessitates complex caregiver roles, often requiring hospital staff training, which caregivers can find distressing when asked to do so for the first time. It is becoming increasingly apparent that caregivers (most often spouses, children, or close family members) might not be adequately informed about, prepared for, or trained for the tasks and roles they will encounter during the treatment and recovery phases of this unique patient population, which span both technical and emotional support.<a href="#cite_note-:4-121">[121]</a> Of note, caregivers of patients who report lower quality of life demonstrate increased burden and fatigue that extend beyond the treatment phase. Examples of technically difficult caregiver duties include tube feeding, oral suctioning, wound maintenance, medication delivery safe for tube feeding, and troubleshooting home medical equipment. If the cancer affects the mouth or larynx, caregivers must also find a way to effectively communicate among themselves and with their healthcare team. This is in addition to providing emotional support for the person undergoing cancer therapy.<a href="#cite_note-:4-121">[121]</a> <div class="mw-heading mw-heading3"><h3 id="Others">Others</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=39" title="Edit section: Others">edit</a>]</div> Like any <a href="/wiki/Cancer" title="Cancer">cancer</a>, <a href="/wiki/Metastasis" title="Metastasis">metastasis</a> affects many areas of the body as the cancer spreads from cell to cell and <a href="/wiki/Organ_(biology)" title="Organ (biology)">organ</a> to organ. For example, if it spreads to the <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a>, it will prevent the body from producing enough <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cells</a> and affect the proper functioning of the <a href="/wiki/White_blood_cell" title="White blood cell">white blood cells</a> and the body's <a href="/wiki/Immune_system" title="Immune system">immune system</a>; spreading to the <a href="/wiki/Circulatory_system" title="Circulatory system">circulatory system</a> will prevent oxygen from being transported to all the cells of the body; and throat cancer can throw the <a href="/wiki/Nervous_system" title="Nervous system">nervous system</a> into chaos, making it unable to properly regulate and control the body.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=40" title="Edit section: Epidemiology">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Mouth_and_oropharynx_cancers_world_map_-_Death_-_WHO2004.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/Mouth_and_oropharynx_cancers_world_map_-_Death_-_WHO2004.svg/220px-Mouth_and_oropharynx_cancers_world_map_-_Death_-_WHO2004.svg.png" decoding="async" width="220" height="97" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/Mouth_and_oropharynx_cancers_world_map_-_Death_-_WHO2004.svg/330px-Mouth_and_oropharynx_cancers_world_map_-_Death_-_WHO2004.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e0/Mouth_and_oropharynx_cancers_world_map_-_Death_-_WHO2004.svg/440px-Mouth_and_oropharynx_cancers_world_map_-_Death_-_WHO2004.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption><a href="/wiki/Age_adjustment" title="Age adjustment">Age-standardized</a> death from oro-pharyngeal cancer per 100,000 inhabitants in 2004<a href="#cite_note-122">[122]</a><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1184024115"><div class="div-col div-col-small" style="column-width: 10em;"> <style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend">  no data</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  less than 2</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  2-4</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  4-6</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  6-8</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  8-10</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  10-12</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  12-14</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  14-16</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  16-18</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  18-20</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  20-25</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  more than 25</div> </div></figcaption></figure> Globally, head and neck cancer accounts for 650,000 new cases of cancer and 330,000 deaths annually on average. In 2018, it was the seventh most common cancer worldwide, with 890,000 new cases documented and 450,000 people dying from the disease.<a href="#cite_note-:3-12">[12]</a> The risk of developing head and neck cancer increases with age, especially after 50 years. Most people who do so are between 50 and 70 years old.<a href="#cite_note-ridge-22">[22]</a> In North America and Europe, the tumors usually arise from the oral cavity, oropharynx, or larynx, whereas nasopharyngeal cancer is more common in the Mediterranean countries and in the Far East. In Southeast China and Taiwan, head and neck cancer, specifically <a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">nasopharyngeal cancer</a>, is the most common cause of death in young men.<a href="#cite_note-123">[123]</a> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=41" title="Edit section: United States">edit</a>]</div> In the United States, head and neck cancer makes up 3% of all cancer cases (averaging 53,000 new diagnoses per year) and 1.5% of cancer deaths.<a href="#cite_note-124">[124]</a> The 2017 worldwide figure cites head and neck cancers as representing 5.3% of all cancers (not including non-melanoma skin cancers).<a href="#cite_note-pmid31560378-125">[125]</a><a href="#cite_note-Aupérin_178–186-5">[5]</a> Notably, head and neck cancer secondary to chronic alcohol or tobacco use has been steadily declining as less of the population chronically smokes tobacco.<a href="#cite_note-:3-12">[12]</a> However, HPV-associated oropharyngeal cancer is rising, particularly in younger people in westernized nations, which is thought to be reflective of changes in oral sexual practices, specifically with regard to the number of oral sexual partners.<a href="#cite_note-Aupérin_178–186-5">[5]</a><a href="#cite_note-:3-12">[12]</a> This increase since the 1970s has mostly affected wealthier nations and male populations.<a href="#cite_note-Gillison_2014-126">[126]</a><a href="#cite_note-Gillison_2015-127">[127]</a><a href="#cite_note-Aupérin_178–186-5">[5]</a> This is due to evidence suggesting that transmission rates of HPV from women to men are higher than from men to women, as women often have a higher immune response to infection.<a href="#cite_note-Aupérin_178–186-5">[5]</a><a href="#cite_note-pmid25043222-128">[128]</a> <ul><li>In 2008, there were 22,900 cases of oral cavity cancer, 12,250 cases of laryngeal cancer, and 12,410 cases of pharyngeal cancer in the United States.<a href="#cite_note-ridge-22">[22]</a></li> <li>In 2002, 7,400 Americans were projected to die of these cancers.<a href="#cite_note-ACS-129">[129]</a></li> <li>More than 70% of throat cancers are at an advanced stage when discovered.<a href="#cite_note-NCH-130">[130]</a></li> <li>Men are 89% more likely than women to be diagnosed with these cancers and are almost twice as likely to die of them.<a href="#cite_note-ACS-129">[129]</a></li> <li>African Americans are disproportionately affected by head and neck cancer, with younger ages of incidence, increased mortality, and more advanced disease at presentation.<a href="#cite_note-Gourin_C,_Podolsky_R_2006_1093–106-114">[114]</a> Laryngeal cancer incidence is higher in African Americans relative to white, Asian, and Hispanic populations. There is a lower survival rate for similar tumor states in African Americans with head and neck cancer.<a href="#cite_note-ridge-22">[22]</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=42" title="Edit section: Research">edit</a>]</div> Immunotherapy with immune checkpoint inhibitors is being investigated in head and neck cancers.<a href="#cite_note-131">[131]</a> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=43" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-NCI-1">^ <a href="#cite_ref-NCI_1-0">a</a> <a href="#cite_ref-NCI_1-1">b</a> <a href="#cite_ref-NCI_1-2">c</a> <a href="#cite_ref-NCI_1-3">d</a> <a href="#cite_ref-NCI_1-4">e</a> <a href="#cite_ref-NCI_1-5">f</a> <a href="#cite_ref-NCI_1-6">g</a> <a href="#cite_ref-NCI_1-7">h</a> <a href="#cite_ref-NCI_1-8">i</a> <a href="#cite_ref-NCI_1-9">j</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cancer.gov/types/head-and-neck/patient/adult/oropharyngeal-treatment-pdq">"Oropharyngeal Cancer Treatment (Adult) (PDQ®)–Patient Version"</a>. 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class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Head_and_neck_cancer&action=edit&section=44" title="Edit section: External links">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output 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href="https://www.macmillan.org.uk/cancer-information-and-support/head-and-neck-cancer">Head and neck cancer</a> at <a href="/wiki/Macmillan_Cancer_Support" title="Macmillan Cancer Support">Macmillan Cancer Support</a> (UK)</li> <li><a rel="nofollow" class="external text" href="http://www.radiologyinfo.org/en/info.cfm?pg=hdneck">Head and Neck Cancer Treatment</a> at <a href="/wiki/RadiologyInfo" class="mw-redirect" title="RadiologyInfo">RadiologyInfo</a></li> <li><a rel="nofollow" class="external text" href="http://www.cancer.net/cancer-types/head-and-neck-cancer">Head and Neck Cancer</a> at Cancer.net (<a href="/wiki/American_Society_of_Clinical_Oncology" title="American Society of Clinical Oncology">American Society of Clinical Oncology</a>)</li> <li><a rel="nofollow" class="external text" href="https://hancuk.org/">Head and Neck Cancer UK</a> (HANCUK)</li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output 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dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1783924" class="extiw" title="d:Q1783924">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/C07">C07</a>–<a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/C14">C14</a> <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/C32">C32</a>–<a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/C33">C33</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=140">140</a>–<a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=149">149</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D006258">D006258</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/Pharyngeal-Cancer">Head and neck cancer</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Overview_of_tumors,_cancer_and_oncology" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Tumors" title="Template:Tumors"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Tumors" title="Template talk:Tumors"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Tumors" title="Special:EditPage/Template:Tumors"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Overview_of_tumors,_cancer_and_oncology" style="font-size:114%;margin:0 4em">Overview of <a href="/wiki/Neoplasm" title="Neoplasm">tumors</a>, <a href="/wiki/Cancer" title="Cancer">cancer</a> and <a href="/wiki/Oncology" title="Oncology">oncology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Conditions</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Benign_tumor" title="Benign tumor">Benign tumors</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hyperplasia" title="Hyperplasia">Hyperplasia</a></li> <li><a href="/wiki/Cyst" title="Cyst">Cyst</a></li> <li><a href="/wiki/Pseudocyst" title="Pseudocyst">Pseudocyst</a></li> <li><a href="/wiki/Hamartoma" title="Hamartoma">Hamartoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Malignant progression</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dysplasia" title="Dysplasia">Dysplasia</a></li> <li><a href="/wiki/Carcinoma_in_situ" title="Carcinoma in situ">Carcinoma in situ</a></li> <li><a href="/wiki/Cancer" title="Cancer">Cancer</a></li> <li><a href="/wiki/Metastasis" title="Metastasis">Metastasis</a></li> <li><a href="/wiki/Primary_tumor" title="Primary tumor">Primary tumor</a></li> <li><a href="/wiki/Sentinel_lymph_node" title="Sentinel lymph node">Sentinel lymph node</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Topography</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Head and neck</a> <ul><li><a href="/wiki/Oral_cancer" title="Oral cancer">oral</a></li> <li><a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">oropharyngeal</a></li> <li><a href="/wiki/Laryngeal_cancer" title="Laryngeal cancer">laryngeal</a></li> <li><a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">nasopharyngeal</a></li></ul></li> <li><a href="/wiki/Digestive_system_neoplasm" title="Digestive system neoplasm">Digestive system</a></li> <li><a href="/wiki/Neoplasm" title="Neoplasm">Respiratory system</a></li> <li><a href="/wiki/Bone_tumor" title="Bone tumor">Bone</a></li> <li><a href="/wiki/Skin_cancer" title="Skin cancer">Skin</a></li> <li><a href="/wiki/Leukemia" title="Leukemia">Blood</a></li> <li><a href="/wiki/Urogenital_neoplasm" title="Urogenital neoplasm">Urogenital</a></li> <li><a href="/wiki/Nervous_system_neoplasm" title="Nervous system neoplasm">Nervous system</a></li> <li><a href="/wiki/Endocrine_gland_neoplasm" title="Endocrine gland neoplasm">Endocrine system</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Histology</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carcinoma" title="Carcinoma">Carcinoma</a></li> <li><a href="/wiki/Sarcoma" title="Sarcoma">Sarcoma</a></li> <li><a href="/wiki/Blastoma" title="Blastoma">Blastoma</a></li> <li><a href="/wiki/Papilloma" title="Papilloma">Papilloma</a></li> <li><a href="/wiki/Adenoma" title="Adenoma">Adenoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Precancerous_condition" title="Precancerous condition">Precancerous condition</a></li> <li><a href="/wiki/Paraneoplastic_syndrome" title="Paraneoplastic syndrome">Paraneoplastic syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cancer_staging" title="Cancer staging">Staging</a>/<a href="/wiki/Grading_(tumors)" title="Grading (tumors)">grading</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/TNM_staging_system" title="TNM staging system">TNM</a></li> <li><a href="/wiki/Ann_Arbor_staging" title="Ann Arbor staging">Ann Arbor</a></li> <li><a href="/wiki/Prostate_cancer_staging" title="Prostate cancer staging">Prostate cancer staging</a></li> <li><a href="/wiki/Gleason_grading_system" title="Gleason grading system">Gleason grading system</a></li> <li><a href="/wiki/Dukes_classification" class="mw-redirect" title="Dukes classification">Dukes classification</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Carcinogenesis" title="Carcinogenesis">Carcinogenesis</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cancer_cell" title="Cancer cell">Cancer cell</a></li> <li><a href="/wiki/Carcinogen" title="Carcinogen">Carcinogen</a></li> <li><a href="/wiki/Tumor_suppressor_gene" title="Tumor suppressor gene">Tumor suppressor genes</a>/<a href="/wiki/Oncogene" title="Oncogene">oncogenes</a></li> <li><a href="/wiki/Clonally_transmissible_cancer" title="Clonally transmissible cancer">Clonally transmissible cancer</a></li> <li><a href="/wiki/Oncovirus" title="Oncovirus">Oncovirus</a></li> <li><a href="/wiki/Carcinogenic_bacteria" title="Carcinogenic bacteria">Carcinogenic bacteria</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Misc.</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cancer_research" title="Cancer research">Research</a></li> <li><a href="/wiki/Index_of_oncology_articles" title="Index of oncology articles">Index of oncology articles</a></li> <li><a href="/wiki/History_of_cancer" title="History of cancer">History</a></li> <li><a href="/wiki/Cancer_pain" title="Cancer pain">Cancer pain</a></li> <li><a href="/wiki/Cancer_and_nausea" title="Cancer and nausea">Cancer and nausea</a></li> <li><a href="/wiki/Diet_and_cancer" title="Diet and cancer">Diet</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Tumors_of_lip,_oral_cavity_and_pharynx_/_head_and_neck_cancer" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Tumors_of_lip,_oral_cavity_and_pharynx" title="Template:Tumors of lip, oral cavity and pharynx"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Tumors_of_lip,_oral_cavity_and_pharynx" title="Template talk:Tumors of lip, oral cavity and pharynx"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Tumors_of_lip,_oral_cavity_and_pharynx" title="Special:EditPage/Template:Tumors of lip, oral cavity and pharynx"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Tumors_of_lip,_oral_cavity_and_pharynx_/_head_and_neck_cancer" style="font-size:114%;margin:0 4em"><a href="/wiki/Neoplasm" title="Neoplasm">Tumors</a> of <a href="/wiki/Lip" title="Lip">lip</a>, <a href="/wiki/Human_mouth" title="Human mouth">oral cavity</a> and <a href="/wiki/Pharynx" title="Pharynx">pharynx</a> / <a class="mw-selflink selflink">head and neck cancer</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oral_cancer" title="Oral cancer">Oral cancer</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Salivary_gland_neoplasm" class="mw-redirect" title="Salivary gland neoplasm">Salivary gland</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">malignant epithelial tumors</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acinic_cell_carcinoma" title="Acinic cell carcinoma">Acinic cell carcinoma</a></li> <li><a href="/wiki/Mucoepidermoid_carcinoma" title="Mucoepidermoid carcinoma">Mucoepidermoid carcinoma</a></li> <li><a href="/wiki/Adenoid_cystic_carcinoma" title="Adenoid cystic carcinoma">Adenoid cystic carcinoma</a></li> <li><a href="/wiki/Salivary_duct_carcinoma" title="Salivary duct carcinoma">Salivary duct carcinoma</a></li> <li><a href="/wiki/Epithelial-myoepithelial_carcinoma" title="Epithelial-myoepithelial carcinoma">Epithelial-myoepithelial carcinoma</a></li> <li><a href="/wiki/Polymorphous_low-grade_adenocarcinoma" title="Polymorphous low-grade adenocarcinoma">Polymorphous low-grade adenocarcinoma</a></li> <li><a href="/wiki/Hyalinizing_clear_cell_carcinoma" title="Hyalinizing clear cell carcinoma">Hyalinizing clear cell carcinoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">benign epithelial tumors</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pleomorphic_adenoma" title="Pleomorphic adenoma">Pleomorphic adenoma</a></li> <li><a href="/wiki/Warthin%27s_tumor" title="Warthin's tumor">Warthin's tumor</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">ungrouped</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Oncocytoma" title="Oncocytoma">Oncocytoma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oral_cancer" title="Oral cancer">Tongue</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Leukoplakia" title="Leukoplakia">Leukoplakia</a></li> <li><a href="/wiki/Rhabdomyoma" title="Rhabdomyoma">Rhabdomyoma</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">Oropharynx</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Human_papillomavirus" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Human_papillomavirus" title="Template:Human papillomavirus"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Human_papillomavirus" title="Template talk:Human papillomavirus"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Human_papillomavirus" title="Special:EditPage/Template:Human papillomavirus"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Human_papillomavirus" style="font-size:114%;margin:0 4em">Human papillomavirus</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_papillomavirus_infection" title="Human papillomavirus infection">Related diseases</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Cancers</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a></li> <li><a href="/wiki/Squamous_cell_carcinoma" class="mw-redirect" title="Squamous cell carcinoma">cancers</a> <ul><li><a href="/wiki/Anal_cancer" title="Anal cancer">Anal</a></li> <li><a href="/wiki/Vaginal_cancer" title="Vaginal cancer">Vaginal</a></li> <li><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">Vulvar</a></li> <li><a href="/wiki/Penile_cancer" title="Penile cancer">Penile</a></li> <li><a class="mw-selflink selflink">Head and neck cancer</a> (<a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">HPV-positive oropharyngeal cancer</a>)</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Wart" title="Wart">Warts</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><ul><li><a href="/wiki/Genital_wart" title="Genital wart">genital</a></li> <li><a href="/wiki/Plantar_wart" title="Plantar wart">plantar</a></li> <li><a href="/wiki/Verruca_plana" class="mw-redirect" title="Verruca plana">flat</a></li> <li><a href="/wiki/Laryngeal_papillomatosis" title="Laryngeal papillomatosis">Laryngeal papillomatosis</a></li> <li><a href="/wiki/Epidermodysplasia_verruciformis" title="Epidermodysplasia verruciformis">Epidermodysplasia verruciformis</a></li> <li><a href="/wiki/Heck%27s_disease" title="Heck's disease">Focal epithelial hyperplasia</a></li> <li><a href="/wiki/Papilloma" title="Papilloma">Papilloma</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Others</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">Acrochordon (<a href="/wiki/Skin_tag" title="Skin tag">skin tags</a>)</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vaccine" title="Vaccine">Vaccine</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccines</a> <ul><li><a href="/wiki/Cervarix" title="Cervarix">Cervarix</a></li> <li><a href="/wiki/Gardasil" title="Gardasil">Gardasil</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Screening_(medicine)" title="Screening (medicine)">Screening</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pap_test" title="Pap test">Pap test</a>: <ul><li><a href="/wiki/Papanicolaou_stain" title="Papanicolaou stain">stain</a></li></ul></li> <li><a href="/wiki/Bethesda_system" title="Bethesda system">Bethesda system</a> <ul><li><a href="/wiki/Cytopathology" title="Cytopathology">Cytopathology</a></li> <li><a href="/wiki/Cytotechnology" title="Cytotechnology">Cytotechnology</a></li></ul></li> <li>Experimental techniques: <ul><li><a href="/wiki/Speculoscopy" title="Speculoscopy">Speculoscopy</a></li> <li><a href="/wiki/Cervicography" title="Cervicography">Cervicography</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Colposcopy" title="Colposcopy">Colposcopy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Biopsy <a href="/wiki/Histology" title="Histology">histology</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_intraepithelial_neoplasia" title="Cervical intraepithelial neoplasia">Cervical intraepithelial neoplasia (CIN)</a></li> <li><a href="/wiki/Koilocyte" title="Koilocyte">Koilocyte</a></li> <li><a href="/wiki/Vaginal_intraepithelial_neoplasia" title="Vaginal intraepithelial neoplasia"> Vaginal intraepithelial neoplasia (VAIN)</a></li> <li><a href="/wiki/Vulvar_intraepithelial_neoplasia" title="Vulvar intraepithelial neoplasia"> Vulvar intraepithelial neoplasia (VIN)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Treatment</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_conization" title="Cervical conization">Cervical conization</a></li> <li><a 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