What is Head and Neck Cancer?

anatomy head.jpgOral cavity and oropharyngeal cancers, or more commonly referred to as “head and neck cancers,” are most frequently found in the tongue, tonsils, gums, and behind the mouth, as well as in the lips and glands of the saliva. The illustration to the right shows the sites, or locations, in the body that are included in the head and neck cancer regions. 

In 2019, it is estimated that approximately 53,000 people in the United States will get head and neck cancer, and almost 11,000 will die.1  In Maryland, it is expected that close to 900 people will be diagnosed with a head and neck cancer, and almost 200 will die this year.2  About 70% of head and neck cancers are caused by the human papillomavirus (HPV), a group of more than 200 viruses and a very common sexually-transmitted infection. Cases of head and neck cancers have been on the rise of the past several years, and are now considered the most common HPV-associated cancer in the United States.3 

What can cause Head and Neck Cancer?

Head and neck cancers can be caused by several factors, including: 
  • Using tobacco products such as cigarettes, cigars, pipes, and smokeless tobacco;
  • Drinking alcohol, including beer, wine, or liquor;
  • Infection with HPV; 
  • Coming into contact with certain chemicals and substances like wood dust, asbestos, and formaldehyde while on the job; and
  • Getting the Epstein-Barr virus, which can cause mononucleosis (sometimes referred to as “mono”). 4  

What Are the Symptoms?

There are many symptoms of head and neck cancer, with each cancer site presenting themselves differently. It’s important to pay attention to anything in your mouth, throat, or nose that doesn’t feel normal, as they may be a sign of a more severe health problem. Talk to your doctor if you experience any of the following issues: 
  • A white or red sore in the mouth that lasts longer than several weeks and does not heal; 
  • Any bleeding or pain in the mouth or throat that doesn’t seem to go away; 
  • Pain or ringing in your ears; 
  • Pain when swallowing; 
  • Pain or swelling around the eyes, jaw;
  • A lump or thickening in your throat; 
  • Headaches; 
  • Nosebleeds; and 
  • Sinus infections that do not resolve with antibiotics. 

How Can I Prevent Head and Neck Cancer?

As discussed above, alcohol and tobacco use are some of the main causes of head and neck cancers. To lower your risk, try limiting your consumption of these products. Additionally, since many of these cancers are caused by HPV, it is recommended to use condoms during sexual activity, as this may limit the skin’s exposure to an HPV-infected area. 

Cancers of the head and neck do not have any routine screening tests, like a mammogram for breast cancer, or a colonoscopy for colon cancer for instance. However, it is easy to catch these cancers early by paying attention to any symptoms listed above, or asking your provider to do a brief screening during your normal check-ups with a dentist, or primary care doctor. Your doctor may refer you to a specialist to take a biopsy, or tissue sample, of your mouth to get it tested for cancer.5 

You can also do a self-exam by looking inside your mouth in a mirror each month to look for sores, white patches, lumps, or any other changes.  

It is important to catch cancers early. An earlier cancer diagnosis often leads to less invasive treatment, as well as a better chance at survival. Many of the head and neck cancers, if caught at an early stage, have very high survival rates.6  Be sure to talk to your doctor if you have any questions or concerns about your risk or any changes. 

Learn more about HPV and head and neck cancers at the link below:

American Cancer Society-HPV Stories​



(Human Papillomavirus)

HPV is a very common and widespread virus, consisting of more than 150 related viruses. Nearly everyone will be infected in their lifetime. In fact, the Centers for Disease Control and Prevention (CDC) estimates that more than 90% of sexually active men and 80% of sexually active women will be infected with at least one type of HPV at some point in their lives. Around one-half of these infections a​re with a high-risk HPV type.1

  • High-risk HPVs can cause cancer. About a dozen high-risk HPV types have been identified.
  • Low-risk HPVs do not cause cancer but can cause skin warts on or around the genitals, anus, mouth, or throat. 

Most high-risk HPV infections occur without any symptoms, go away within 1 to 2 years, and do not cause cancer. Some HPV infections, however, can persist for many years. Persistent infections with high-risk HPV types can lead to cell changes that, if untreated, may progress to cancer.2

HPV cancer frequency.png 


Getting Vaccinated

HPV print ad_boy.pngThe HPV vaccine can prevent infection with the HPV types that most commonly cause HPV related cancers. 

The CDC recommends the HPV vaccine be given to 11- to 12-year-old boys and girls so they are protected before ever being exposed to the virus. Research has shown that preteens have a better immune response to the vaccine than those in their late teens and early 20s.3 Vaccination recommendations include:
  • The CDC recommends that 11- to 14-year-olds receive only two doses of HPV vaccine at least six months apart rather than the previously recommended three doses
  • Teens and young adults who start the series later, at ages 15 through 26 years, will continue to need three doses of HPV vaccine to protect against cancer-causing HPV infection.4  
  • The vaccine is also recommended for any man who has sex with men through age 26, and for men with compromised immune systems (including HIV) through age 26, if they did not get the HPV vaccine when they were younger.5
  • In October 2018, the Food and Drug Administration (FDA) approved the expanded use of the HPV vaccine Gardasil 9 to include people 27-45 years old. The CDC’s Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts who make recommendations on the use of vaccines, will review the FDA’s expanded age range vote on recommendation in 2019. If the ACIP recommends that individuals 27-45 year old receive the vaccine, insurance companies may cover the cost for patients in that age group.
  • Young women can get the HPV vaccine through age 26, and young men can get vaccinated through age 21.

Vaccine best at 11-12 years.png 

Tools and Resources

​​Información en español (Information in Spanish)

 For the General Public: 

Page Viewer


For Health Professionals:​​


Vaccinating against HPV at Age 11-12: Show Me the Evidence


 Vaccinating against HPV at Age 11-12: Show Me the Evidence

Order "Fact Sheets for Parents"
Providers may order the "Fact Sheet for Parents" (English and Spanish) from MDH in bulk at no cost.  Fact sheets are available in packs of 25. 
 To order, please completely fill out the order form​​​​​​​ with the number of packs your practice requests.  The number of packs ordered will be mailed to you after MDH receives your request.​
National HPV Vaccination Roundtable Resources
The National HPV Vaccination Roundtable has created an extensive library of resources that includes educational material for parents, educational materials for health professionals, and various toolkits. Please visit http://hpvroundtable.org/resource-library/​ to learn more. 

Every health care professional plays an important role in increasing HPV vaccination rates.  Members of the Provider Training Task Group developed a suite of 6 Clinician & System Action Guides to encourage providers, support teams, and health systems to take action today.

Clinical Guides
Physicians, Physician Assistants & Nurse Practitioners                        

Systems Guides