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<<   作成日時 : 2009/08/11 00:22   >>

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画像 口腔咽頭癌の死亡率は人種差が大きく、アフリカ系アメリカ人患者は白人より早く死亡する確率が高い。原因としてのHPVウイルスによる発症率の違いが予後に影響している。HPV陽性の患者は陰性患者に比べて治療成績が良好である。咽頭癌の半数の患者がHPV陽性だが、黒人は大部分が陰性で、HPV陽性癌の98%が白人であった。HPV陽性の場合の生存率には黒人と白人で差はなかった。
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口腔ガンが急増/米国 口腔・咽頭がん
http://kurie.at.webry.info/200810/article_37.html
男性の口腔がんはHPVと関連している
http://kurie.at.webry.info/200805/article_25.html
HPVによる男性の上咽頭癌の増加
http://kurie.at.webry.info/200802/article_9.html
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Viral Infection May Explain Racial Differences in Oral Cancer Death Rates
http://www.nytimes.com/2009/08/04/health/04disp.html
By RONI CARYN RABIN
Published: July 31, 2009

African-American patients with head and neck cancers die earlier than whites, and researchers say they have made a breakthrough in understanding the underlying reasons for the racial gap.

After scientists at the University of Maryland noticed that whites treated at their hospital for squamous cell head and neck cancers lived more than twice as long as black patients who received the same care at their hospital, they took a closer look. Further analysis revealed that the gap was almost entirely due to differences in survival among patients with cancer of the throat and tonsils, or oropharyngeal cancer.

The scientists were also involved in analyzing specimens of head and neck tumors taken from participants in a treatment trial called the TAX 324 study, to see how many tumors were linked to the human papillomavirus, the same HPV-16 virus that has been linked to cervical cancer.

The results were striking: they found that patients whose tumors were HPV-positive did much better after treatment than patients who were negative for the virus. Yet while half of the throat cancer patients had HPV-positive tumors, 98 percent of the positive tumors were from white patients, while a vast majority of black patients had HPV-negative tumors.

“There was no difference in the survival between black and white patients in the TAX 324 trials, if you subtracted out the HPV-positive patients,” said Dr. Kevin Cullen, the senior author of a paper published online by the journal Cancer Prevention Research. White patients who were HPV-negative fared as poorly as the HPV-negative blacks, he said.

Experts say the challenge for doctors now is to explore new treatments for HPV-negative patients, whether black or white.

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Published Online First on July 29, 2009
[Cancer Prevention Research, 10.1158/1940-6207.CAPR-09-0150]

Oropharyngeal Cancer, Race, and the Human Papillomavirus
Otis W. Brawley

Author's Affiliation: American Cancer Society; Departments of Hematology and Oncology (Emory University School of Medicine) and Epidemiology (Rollins School of Public Health), Emory University, Atlanta, Georgia

Requests for reprints: Otis W. Brawley, American Cancer Society, 250 Williams Street, Atlanta, GA 30303. Phone: 404-329-7740; Fax: 404-329-7530; E-mail: Otis.Brawley@Cancer.Org.

This perspective on Settle et al. discusses the racial disparity in oropharyngeal cancer survival in relation to the biological factor human papillomavirus and its association with sexual behavior. This discussion is expanded to a more general consideration of biological and nonbiological (e.g., socioeconomic and cultural) factors affecting racial disparities in disease..

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