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Kreft i orofarynks

Sist revidert:
Sist revidert av:


Definisjon:
Kreft i munnhule og svelg er relatert til bruk av røyk og alkohol, men de siste årene har HPV-infeksjon blitt en viktig etiologisk faktor
Forekomst:
Antall nye tilfeller i 2021 var 270, av disse var 204 menn og 66 kvinner
Symptomer:
Sparsomme symptomer lenge. Sårhet i halsen, ev. bolusfornemmelse, i senere stadium smerter og svelgebesvær
Funn:
Mer enn halvparten av karsinomene er i tonsillene, resten er omtrent likt fordelt på tungebasis og den bløte ganen, noen finnes også på bakveggen
Diagnostikk:
Tilleggsundersøkelser er biopsi, røntgen, CT, MRI og endoskopi
Behandling:
Kirurgi og strålebehandling
  1. Helsedirektoratet. Nasjonalt handlingsprogram med retningslinjer for diagnostikk, behandling og oppfølging av hode-/halskreft. 2020. ekstranett.helse-midt.no  
  2. Mehanna H, Jones TM, Gregoire V, Kian Ang K. Oropharyngeal carcinoma related to human papillomavirus. BMJ 2010; 340: c1439. BMJ (DOI)  
  3. Nasman A, Attner P, Hammarstedt L, Du J, Eriksson M, Giraud G, et al. Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: an epidemic of viral-induced carcinoma? Int J Cancer 2009; 125: 362-6. PubMed  
  4. Mehanna H, Beech T, Nicholson T, et al. Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer—systematic review and meta-analysis of trends by time and region. Head Neck 2013;35:747–55
  5. Moore KA, Mehta V. The growing epidemic of HPV-positive oropharyngeal carcinoma: A clinical review for primary care providers. J Am Board Fam Med 2015; 28: 498-503. PubMed  
  6. Worden FP, Kumar B, Lee JS, Wolf GT, Cordell KG, Taylor JM, et al. Chemoselection as a strategy for organ preservation in advanced oropharynx cancer: response and survival positively associated with HPV16 copy number. J Clin Oncol 2008; 26: 3138-46. PubMed  
  7. O'Rorke MA, Ellison MV, Murray LJ, Moran M, James J, Anderson LA. Human papillomavirus related head and neck cancer survival: a systematic review and meta-analysis. Oral Oncol 2012;48:1191–201
  8. Dahlstrom KR, Li G, Tortolero-Luna G, Wei Q, Sturgis EM. Differences in history of sexual behavior between patients with oropharyngeal squamous cell carcinoma and patients with squamous cell carcinoma at other head and neck sites. Head Neck. 2011 Jun;33(6):847-55. doi: 10.1002/hed.21550 DOI  
  9. McIlwain WR, Sood AJ, Nguyen SA, Day TA. Initial symptoms in patients with HPV-positive and HPV-negative oropharyngeal cancer. JAMA Otolaryngol Head Neck Surg 2014;140:441–7
  10. Dahlstrand H, Näsman A, Romanitan M, Lindquist D, Ramqvist T, Dalianis T. Human papillomavirus accounts both for increased incidence and better prognosis in tonsillar cancer. Anticancer Res 2008; 28: 1133-8. PubMed  
  11. Lüscher M, Sengeløv L, et al. Oropharynxcancer. Lægehåndbogen, sist oppdatert 26.07.2017.
  12. Harris J, Wheeler R, Weber R, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010; 363: 24-35. doi: 10.1056/NEJMoa0912217 DOI  
  13. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, et al. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 2008; 100: 261-9. PubMed  
  14. Cramer JD, Grauer J, Sukari A et al. Incidence of Second Primary Lung Cancer After Low-Dose Computed Tomography vs Chest Radiography Screening in Survivors of Head and Neck Cancer: A Secondary Analysis of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2021 Oct 28. Epub ahead of print. PMID: 34709369.
  15. Cancer in Norway 2021. Cancer Registry of Norway, Institute of Population-based Research. Oslo, Norway. www.kreftregisteret.no  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Olbjørn Klepp, professor dr.med, Norges teknisk-naturvitenskapelige universitet og overlege Kreftavd. Regionsykehuset i Trondheim
  • Stein Helge Glad Nordahl, øre-nese-hals spesialist, overlege Haukeland sykehus, Bergen