Department of Otolaryngology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1189, New York, New York 10029, USA.
Oncologist. 2013;18(2):180-9. doi: 10.1634/theoncologist.2012-0200. Epub 2013 Jan 23.
The International Agency for Research on Cancer and the National Cancer Institute have acknowledged human papillomavirus (HPV)-16 as an independent risk factor for oropharyngeal cancer (OPC). HPV-positive oropharyngeal cancer (HPVOPC) is a sexually transmitted entity that is on the rise; within the next 10 years, the annual number of HPV-associated OPC cases is projected to exceed the annual number of cervical cancer cases in the United States. Recognition of HPV status in OPC has broad implications beyond the traditional oncological concerns of timely diagnosis, accurate staging, and appropriate treatment of cancer patients. The National Comprehensive Cancer Network recommends testing the tumor site for HPV-status during OPC management; it is likely this will become a standard component of care for patients with high-probability tumors of the oropharynx. As the practice of HPV testing becomes more common, it behooves providers to be able to adequately address the concerns of patients with HPVOPC. Although there are currently few relevant studies focusing on this population, existing literature on HPV-infected women and patients with cervical cancer strongly supports the concept that patients with HPVOPC need education to optimally address concerns such as self-blame, guilt, intimacy, and interpersonal relationships. When HPV testing is done, it should be accompanied by evidence-driven and patient-centered counseling to best minimize negative psychosocial outcomes and ensure optimum health promotion. Based on the current state of the literature, this article is intended to be a reference for physicians to effectively manage psychosocial outcomes when diagnosing patients with HPV-associated OPC.
国际癌症研究机构和美国国家癌症研究所已经承认人乳头瘤病毒（HPV）-16 是口咽癌（OPC）的一个独立危险因素。HPV 阳性口咽癌（HPVOPC）是一种性传播疾病，其发病率正在上升；在未来 10 年内，HPV 相关 OPC 病例的年发病率预计将超过美国宫颈癌的年发病率。HPV 在 OPC 中的地位的认识不仅超越了癌症患者及时诊断、准确分期和适当治疗的传统肿瘤学关注，还具有广泛的意义。美国国家综合癌症网络建议在 OPC 管理过程中对肿瘤部位进行 HPV 状态检测；这很可能成为对高概率口咽肿瘤患者护理的标准组成部分。随着 HPV 检测的实践越来越普遍，医疗服务提供者有必要能够充分解决 HPVOPC 患者的担忧。尽管目前很少有相关研究关注这一人群，但现有的关于 HPV 感染女性和宫颈癌患者的文献强烈支持这样一种观点，即 HPVOPC 患者需要接受教育，以最佳地解决自责、内疚、亲密关系和人际关系等问题。进行 HPV 检测时，应伴随有循证和以患者为中心的咨询，以最大限度地减少负面的心理社会后果，并确保最佳的健康促进。基于目前的文献状况，本文旨在为医生提供参考，以有效管理诊断 HPV 相关 OPC 患者时的心理社会后果。
