Case study

Uncovering the link between HPV and head and neck cancer

Our scientists have been developing a new screening method that detects human papillomavirus (HPV) in the mouth. They are now using this technique to analyse tissue samples taken from patients to gain a better understanding of how HPV causes head and neck cancer.

Gaps in our knowledge

It is well-known that HPV can cause cancers of the genital tract - predominantly cervical cancer - and we now know that HPV is also associated with a subset of head and neck cancers. These are cancers that arise in the tonsils and base of the tongue (oropharyngeal cancer). We also know that men are particularly at risk of developing these oropharyngeal cancers.

However, there are still huge gaps in our knowledge about HPV and oropharyngeal cancer. Dr Elizabeth Marsh, Senior Lecturer in Cellular and Molecular Biology, explains: “Despite a thorough understanding of the natural history of HPV within a cervical infection, it is still not clear how HPV causes head and neck cancer.

"There are also no screening practices, so most head and neck cancers are not diagnosed until they are in late stage. Therefore, we believe our study will not only improve early detection but also help us to understand the pathophysiology of this disease."

Analysing DNA from tonsils

Thanks to work undertaken over the last couple of years, our research team from the Human Science Research Centre have already developed a new screening method that detects HPV in the mouth. It uses a specialist technique called real-time quantitative PCR.

They are now using this screening method to analyse DNA taken from the tonsils and mouths of patients from the Royal Derby Hospital, looking specifically for the presence of HPV.

Dr Marsh explains the approach: “For our clinical study, we are recruiting patients who are having their tonsils removed as a routine operation - so they are otherwise healthy. We collect their left and right tonsils and a swab of the inside of their mouth.”

These clinical samples will enable the researchers to examine the natural history of HPV in the tonsil. This is where oral HPV infections establish and where pre-cancerous changes occur. If a sample tests positive for HPV, they will then identify:

This should shed light on the viral lifecycle and natural history of HPV within the mouth, which could help develop more effective drugs and treatments.

Image of Elizabeth Marsh
Associate Professor in Cellular and Molecular Biology

Elizabeth is an Associate Professor. She leads the Metabolic Disorders and Cancer Research Centre, teaches across our Undergraduate and Postgraduate Biosciences programmes, and supervises students in their project work. Her research interests are in host-pathogen interactions and immunity, and she leads projects to understand the role of Human Papillomavirus in Head and Neck Cancers.

How lifestyle affects risk

Patients will also be asked to fill in a questionnaire about lifestyle behaviours that are thought to be risk factors for the disease: drinking, smoking and sexual practices.

Through careful analysis of the questionnaire responses combined with the screening results, the team are hoping to find out more about how these lifestyle factors influence the development of HPV.

If a list of risk factors can be identified for oropharyngeal cancer, health professionals and charities could then undertake more accurate and better targeted public health campaigns.

a mother holds a happy child above her head

Human Sciences Research Centre

Our Human Sciences Research Centre conducts theoretical and applied research into the prevention and treatment of diseases and into improvements to the quality of life for people of all ages.

Find out more about our Human Sciences Research CentreFind out more about our Human Sciences Research Centre

Terms explained

Human papillomavirus (HPV) is the name of a very common group of viruses. There are more than 100 different types and they are passed by skin-to-skin contact. Most people will get some type of HPV in their life. They do not cause any problems in most people but some types can cause cancer. HPV affects the skin. 

Oropharyngeal cancer (OPC) is a disease in which abnormal cells with the potential to both grow locally and spread to other parts of the body are found in the tissue of the part of the throat (oropharynx) that includes the base of the tongue, the tonsils, the soft palate and the walls of the pharynx (the cavity between the nose and mouth).

Pathophysiology describes the changes that take place within the body due to a disease or injury.

Real-time quantitative PCR (polymerase chain reaction) is a specialist diagnostic technique that monitors how a specific DNA segment reacts under certain circumstances.

Pathogenic describes anything that can cause disease, such as viruses, bacteria and other types of germs.