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CE:人乳头瘤病毒相关口咽癌:护理考量综述

CE: Human Papillomavirus-Related Oropharyngeal Cancer: A Review of Nursing Considerations.

作者信息

McKiernan Janet, Thom Bridgette

机构信息

Janet McKiernan is an NP and Bridgette Thom is a senior research specialist in the Survivorship Center at the Memorial Sloan Kettering Cancer Center in New York City. Contact author: Janet McKiernan,

出版信息

Am J Nurs. 2016 Aug;116(8):34-43. doi: 10.1097/01.NAJ.0000490170.91898.13.

Abstract

: The overall incidence of head and neck cancer-which includes laryngeal, hypopharyngeal, nasal cavity, paranasal sinus, nasopharyngeal, oral, oropharyngeal, and salivary gland cancers-has declined in the United States over the past 30 years with the concomitant reduction in tobacco use. Over that same period, however, the worldwide incidence of oropharyngeal cancer has escalated significantly, most notably among men and women under age 60 who live in developed countries. This epidemic rise in oropharyngeal cancer is largely attributed to certain genotypes of the human papillomavirus (HPV). In the United States, HPV prevalence in oropharyngeal tumors increased dramatically, from roughly 16% between 1984 and 1989 to nearly 73% between 2000 and 2004, and the annual incidence of HPV-positive oropharyngeal cancer is expected to surpass that of HPV-related cervical cancer by 2020.This article provides an overview of head and neck cancer-its incidence, risk factors, treatment, and posttreatment sequelae-with a focus on HPV-related oropharyngeal cancer. Unlike other forms of head and neck cancer, HPV-related oropharyngeal cancer tends to affect younger patients with few or none of the traditional risk factors and has a distinctive presentation, histology, and natural course. In order to provide appropriate patient education and to help these patients monitor and manage late and long-term treatment effects, it is important for nurses to be aware of this disease and its treatment, and of the unique survivorship issues that arise for affected patients.

摘要

头颈部癌症包括喉癌、下咽癌、鼻腔癌、鼻窦癌、鼻咽癌、口腔癌、口咽癌和唾液腺癌,在过去30年中,随着美国烟草使用量的减少,其总体发病率有所下降。然而,在同一时期,口咽癌的全球发病率显著上升,在发达国家60岁以下的男性和女性中尤为明显。口咽癌的这种流行趋势主要归因于人类乳头瘤病毒(HPV)的某些基因型。在美国,口咽肿瘤中HPV的流行率急剧上升,从1984年至1989年的约16%增至2000年至2004年的近73%,预计到2020年,HPV阳性口咽癌的年发病率将超过HPV相关宫颈癌。本文概述了头颈部癌症——其发病率、危险因素、治疗方法和治疗后后遗症——重点是HPV相关口咽癌。与其他形式的头颈部癌症不同,HPV相关口咽癌往往影响年轻患者,这些患者几乎没有或没有传统危险因素,并且具有独特的临床表现、组织学和自然病程。为了提供适当的患者教育,并帮助这些患者监测和管理晚期及长期治疗效果,护士了解这种疾病及其治疗方法,以及受影响患者出现的独特生存问题非常重要。

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