Human Papillomavirus-Associated Oropharyngeal Cancer: Global Epidemiology and Public Policy Implications

SIMPLE SUMMARY: Head and neck cancers of the oropharyngeal subsite can be driven by the human papillomavirus (HPV). In countries such as the United States, the incidence of HPV-associated oropharyngeal cancer has exceeded that of HPV-associated cervical cancer. HPV vaccination is currently the main preventative approach for HPV-associated oropharyngeal cancer. Globally, both the epidemiology of HPV-associated oropharyngeal cancer and HPV vaccine policy vary. This paper aims to describe regional variations in HPV-associated oropharyngeal cancer, variations in gender-neutral vaccine policy, and future areas of policy-relevant research. ABSTRACT: Global trends in human papillomavirus (HPV)-associated head and neck cancers (HNC), specifically in the oropharynx subsite, have been dynamically changing, leading to new staging and treatment paradigms. Epidemiologic studies have noted regional variations in HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). While HPV vaccination remains the main preventative approach, vaccination policy in relation to gender neutrality is heterogeneous and particularly sparse in low- and middle-income countries, where the burden of global cancer cases and HPV-associated HNC are not well-characterized in certain regions. This review summarizes the existing literature on regional variations of HPV-associated OPSCC and gender-neutral vaccine policies. Based on available data, the incidence of HPV-associated OPSCC is highest in North America, Europe, and Oceania. As of 2022, 122 of 195 (63%) World Health Organization (WHO) member states had incorporated HPV vaccinations nationally; of these, 41 of 122 (34%) member states have introduced gender-neutral vaccine coverage. Future research is needed to describe continued evolving trends in HPV-associated OPSCC, understand underlying risk factors leading to regional variation in disease, and implement gender-neutral policy more broadly.