Increasing awareness and therapeutical options to improve prognosis of HPV positive and HPV negative head and neck cancer

This dissertation examines the knowledge among the Dutch population and general practitioners regarding the human papillomavirus (HPV) as a cause of throat cancer. Among the Dutch population, 30.6% were aware of HPV and only 29.9% of these participants knew about the link between HPV and throat cancer. Awareness of HPV as a risk factor for the development of throat cancer is higher among general practitioners in the Netherlands (72%), but more than a quarter of them are unaware. This knowledge is important for early recognition of the disease and for increasing the HPV vaccination rate. In addition, a number of new drugs are being tested on head and neck cancer cell lines. It has been shown that the antiviral drug Cidofovir causes DNA damage in tumour cells. A PI3K inhibitor also appeared to be able to kill head and neck tumour cells, partly by disrupting the metabolism of the cells. Finally, a CDK4/6 inhibitor (affecting cell division) only appeared to inhibit HPV-negative head and neck tumour cells from growing.
Finally, it is investigated whether the integration of HPV in the DNA of the head and neck tumour cell affects the survival of the patient. HPV integration causes an increase in AKR1C, which plays a role in the energy management of the cell. An increase in AKR1C leads to poorer survival in both HPV-positive and HPV-negative head and neck tumours.