Hep C linked to head and neck cancers

Long associated with liver cancer and non-Hodgkin’s lymphoma, the hepatitis C virus (HCV) for the first time has been associated with certain head and neck cancers. The findings from a study at MD Anderson are published in the Journal of the National Cancer Institute, and could affect how those with the virus are screened, and how those with head and neck cancers are treated.

According to the CDC, about 3.9 million people in the United States are living with chronic HCV. Antiviral medications cure more than 90 percent of patients, says Harrys Torres, M.D., associate professor of Infectious Disease, Infection Control and Employee Health. But if left untreated, chronic hepatitis C can severely damage the liver over time. Currently, there is no vaccination for this condition.

In 2009, MD Anderson opened what remains the only clinic of its kind at a comprehensive cancer center to address the unmet medical needs of its patients with HCV.

“Obviously, a hepatitis C infection could impact how patients respond to cancer therapy,” Torres said. “We also realized that many of our hepatitis C patients were excluded from clinical trials. Curing their viral infection would give them access to necessary cancer therapy.”

When Torres started the clinic, he expected to see a number of patients with liver cancers and non-Hodgkin’s lymphoma. HCV is associated with a 48-fold increased risk of liver cancer, and a two- to three-fold increased risk of non-Hodgkin’s lymphoma. Other recent studies have recognized HCV’s increased association with additional cancers, says Torres, but there was no known association with a significant number of head and neck cancers.

“To our surprise, we saw a number of head and neck cancer patients who tested positive for the hepatitis C virus,” he said. “With this observation, we began to wonder if there was an undiscovered correlation between the two.”

Torres and colleagues conducted a study that revealed 14 percent of patients with oropharyngeal cancers (those occurring in the middle part of the throat) tested positive for HCV antibodies, compared to just 6.5 percent in the control group. In those with non-oropharyngeal cancers (those occurring in the oral and nasal cavities and in the larynx), 20 percent tested positive for HCV antibodies. All findings were highly statistically significant.

Compared to the controls, the researchers found that HCV patients’ risk of developing head and neck cancers was increased 2.4 times for oral cavity cancers, 2.04 times for oropharynx cancers, and 4.96 times for larynx cancers. Patients with HCV-positive head and neck cancers were also more likely to test positive for human papillomavirus (HPV).

This finding, says Torres, is an area of great interest for future research study. Given the association found between the two viruses in this patient population, Torres and colleagues plan to look at other HPV-associated cancers and their possible link to HCV, under MD Anderson’s Moon Shots Program.

Learn more about this effort on MD Anderson's website.