Search

Simple Summary: Head and neck cancers of the oropharyngeal subsite can be driven by the human papillomavirus (HPV). In countries such as the United States, the incidence of HPV-associated oropharyngeal cancer has exceeded that of HPV-associated cervical cancer. HPV vaccination is currently the main preventative approach for HPV-associated oropharyngeal cancer. Globally, both the epidemiology of HPV-associated oropharyngeal cancer and HPV vaccine policy vary. This paper aims to describe regional variations in HPV-associated oropharyngeal cancer, variations in gender-neutral vaccine policy, and future areas of policy-relevant research. Global trends in human papillomavirus (HPV)-associated head and neck cancers (HNC), specifically in the oropharynx subsite, have been dynamically changing, leading to new staging and treatment paradigms. Epidemiologic studies have noted regional variations in HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). While HPV vaccination remains the main preventative approach, vaccination policy in relation to gender neutrality is heterogeneous and particularly sparse in low- and middle-income countries, where the burden of global cancer cases and HPV-associated HNC are not well-characterized in certain regions. This review summarizes the existing literature on regional variations of HPV-associated OPSCC and gender-neutral vaccine policies. Based on available data, the incidence of HPV-associated OPSCC is highest in North America, Europe, and Oceania. As of 2022, 122 of 195 (63%) World Health Organization (WHO) member states had incorporated HPV vaccinations nationally; of these, 41 of 122 (34%) member states have introduced gender-neutral vaccine coverage. Future research is needed to describe continued evolving trends in HPV-associated OPSCC, understand underlying risk factors leading to regional variation in disease, and implement gender-neutral policy more broadly. [ABSTRACT FROM AUTHOR]

Simple Summary: Extracellular vesicles are considered intracellular messengers that exchange proteins, lipids, various types of DNA and RNA, etc. They can be properly collected from many kinds of biofluids, such as blood and saliva. Compared to other substances obtained from liquid biopsy, such as cell-free DNA and circulating tumor cells, extracellular vesicles are a better choice to evaluate the disease since the genetic information is protected by their membranous structure, and thus they are more stable for detection. Extracellular vesicles contain less invasive property compared with other substances, and they are easier to collect from extraction with higher efficiency. Moreover, the roles of extracellular vesicles in multiple physiological and pathological processes are more well-known, entitling them to serve as biomarkers for certain cancers, including head and neck squamous cell carcinoma. This review aims to comprehensively present the current clinical trials at several key stages of tumor diagnosis and treatment, as well as their potential to dynamically monitor head and neck cancers during the whole clinical care process. Head and neck squamous cell carcinomas (HNSCCs) arising from different anatomical sites present with different incidences and characteristics, which requires a personalized treatment strategy. Despite the extensive research that has conducted on this malignancy, HNSCC still has a poor overall survival rate. Many attempts have been made to improve the outcomes, but one of the bottlenecks is thought to be the lack of an effective biomarker with high sensitivity and specificity. Extracellular vesicles (EVs) are secreted by various cells and participate in a great number of intercellular communications. Based on liquid biopsy, EV detection in several biofluids, such as blood, saliva, and urine, has been applied to identify the existence and progression of a variety of cancers. In HNSCC, tumor-derived EVs exhibit many functionalities by transporting diverse cargoes, which highlights their importance in tumor screening, the determination of multidisciplinary therapy, prediction of prognosis, and evaluation of therapeutic effects. This review illustrates the classification and formation of EV subtypes, the cargoes conveyed by these vesicles, and their respective functions in HNSCC cancer biology, and discloses their potential as biomarkers during the whole process of tumor diagnosis, treatment, and follow-up. [ABSTRACT FROM AUTHOR]