Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Chapter 1 - Epidemiology, Risk Factors and Pathogenesis of Squamous Cell Tumours


  • HNSCC encompasses a heterogeneous group of upper aerodigestive malignancies originating in the lip, oral cavity, pharynx and larynx
  • It is the sixth most common cancer worldwide, accounting for 1%–2% of all cancer-related deaths
  • Historically, HNSCC has been associated with tobacco smoking and alcohol use
  • Globally, the incidence of tobacco-related HNSCC is associated with patterns of tobacco use and is decreasing in countries with declining rates of tobacco consumption
  • In the past decade, infection with high-risk HPV and especially with HPV16 has been implicated in the pathogenesis of a growing subset of HNSCCs, mainly those arising from the oropharynx
  • HPV-related OPC represents a distinct entity in terms of biology and clinical behaviour
  • Five-year survival rates for all stages of HNSCC is approximately 65%. High cure rates are reported with localised and locoregional disease, but prognosis is dismal for recurrent or metastatic disease
  • For HNSCC, malignant transformation of normal mucosa to invasive carcinoma follows a molecular progression model of multistep carcinogenesis
  • Tobacco-related HNSCC demonstrates mutation of the p53 gene and downregulation of the p16 protein
  • On the contrary, HPV-associated OPC is typically characterised by wild-type p53 and Rb genes and upregulation of p53 protein levels

Further Reading

Chaturvedi AK, Engels EA, Anderson WF, Gillison ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 2008; 26:612–619.

Gatta G, Botta L, Sánchez MJ, et al. Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: The EUROCARE-5 population-based study. Eur J Cancer 2015; 51:2130–2143. 

Hashibe M, Brennan P, Chuang SC, et al. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev 2009; 18:541–550.

Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin 2010; 60:277–300.

Klein JD, Grandis JR. The molecular pathogenesis of head and neck cancer. Cancer Biol Ther 2010; 9:1–7.

Marur S, D’Souza G, Westra WH, Forastiere AA. HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol 2010; 11:781–789.

Park BJ, Chiosea SI, Grandis JR. Molecular changes in the multistage pathogenesis of head and neck cancer. Cancer Biomark 2010; 9:325–339.

Psyrri A, Rampias T, Vermorken JB. The current and future impact of human papillomavirus on treatment of squamous cell carcinoma of the head and neck. Ann Oncol 2014; 25:2101–2115.

Psyrri A, Seiwert TY, Jimeno A. Molecular pathways in head and neck cancer: EGFR, PI3K, and more. Am Soc Clin Oncol Educ Book 2013:246–255. 

Rampias T, Sasaki C, Psyrri A. Molecular mechanisms of HPV induced carcinogenesis in head and neck. Oral Oncol 2014; 50:356–363. 

Rettig EM, D’Souza G. Epidemiology of head and neck cancer. Surg Oncol Clin N Am 2015; 24:379–396.


This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.