Recent research co-authored by Professor of Community Health Karl Kelsey indicates that there is no association between alcohol- and tobacco-induced head and neck cancers and similar cancers correlated with HPV16.
Human papillomavirus, commonly called HPV, is a broad category of DNA-based viruses that infect approximately 20 million Americans, according to the Centers for Disease Control and Prevention. HPV16, a type of HPV, is known for causing over half of the cervical cancer cases in the United States, but it also increases the risk of some types of head and neck cancer.
It is also known that alcohol use and tobacco use - independent of HPV16 - increase the risk of head and neck cancer. In 2000, Kelsey's research team set out to examine the multiplicative risk increase caused by a combination of substance abuse and HPV16. Kelsey, also the director of the Center for Environmental Health and Technology, has served as the director of epidemiology and laboratory work for the research team.
In collaboration with the pharmaceutical company Merck, whose female-only drug Gardasil is the sole vaccine against HPV-related diseases, the team studied 485 head and neck cancer patients in the greater Boston area and 549 cancer-free comparison subjects.
Kelsey's team's results, published on Nov. 27 in the Journal of the National Cancer Institute, found that alcohol and tobacco use does not further amplify the risk of contracting HPV16-associated head and neck cancer. "When you look at diseases associated with HPV16, there is no additive effect of smoking and drinking," he told The Herald.
The head and neck cancers caused by HPV16 and those caused by the use of such substances "can be spoken of almost as different diseases," said Kelsey. "It's very likely that it really is important to classify HPV-positive disease separately just like it is to classify different stages of disease differently."
According to this research, smoking and drinking will not increase the risk of cancer even if someone already has HPV16. "You can never go out and smoke and drink without long-term consequence" even if you have already contracted HPV16, said Kelsey. "There is no question that smoking and drinking is always bad for you."
With these findings, Kelsey supports the creation and implementation of a version of Gardasil for males. The results have "real public health implications," Kelsey said.
"In the case of a disease that is sexually transmitted, it doesn't make sense to vaccinate one gender. I think that is rather shortsighted," Kelsey said. "The way forward is clear. Someone has to test it in males."
Kelsey emphasized that there is "still a lot of work to do."
"I believe that we are still sufficiently ignorant," he said. "We're continuing to accrue cases and controls. This is an exciting time to be studying the disease."
Others on Kelsey's team included researchers from the Harvard School of Public Health, the University of Brunel in London, Louisiana State University, Boston University, the Dana-Farber Cancer Institute and Merck.
