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Pathology · single question

Which of the following is TRUE about Human Papillomavirus (HPV) and oropharyngeal cancer?

  1. HPV has no relationship to oropharyngeal cancer
  2. HPV-associated oropharyngeal cancer is more common in females
  3. HPV (especially HPV-16) is the most common cause of oropharyngeal cancer
  4. HPV-associated oral cancer affects mainly the lips
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Correct answer: C. HPV (especially HPV-16) is the most common cause of oropharyngeal cancer

HPV-16 is now the most common cause of oropharyngeal squamous cell carcinoma (OPSCC) in developed countries, surpassing tobacco and alcohol. HPV-associated OPSCC: (1) most commonly affects the tonsils, base of tongue, and soft palate; (2) is MORE COMMON in MALES (3:1 ratio); (3) typically affects middle-aged adults; (4) has a BETTER prognosis than HPV-negative OPSCC; (5) associated with sexual behavior (oral sex). HPV-16 and HPV-18 are the high-risk oncogenic types.
  • A. Incorrect. HPV has a well-established causal relationship with oropharyngeal cancer — HPV-16 is now the leading cause of OPSCC.
  • B. CORRECT. HPV (specifically HPV-16) is the most common cause of oropharyngeal squamous cell carcinoma — affecting the tonsils, base of tongue, and posterior oropharynx.
  • C. Incorrect. HPV-associated oropharyngeal cancer is significantly MORE COMMON in MALES (male:female ratio approximately 3:1) — not females.
  • D. Incorrect. HPV-associated oral cancer primarily affects the oropharynx (tonsils, base of tongue) — not the lips. Lip cancer is more associated with UV exposure.

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