Prevalence of high-risk human papillomavirus infection and cancer gene mutations in nonmalignant tonsils

Head and neck squamous cell carcinoma (SCC) accounts for approximately 600,000 new cancer cases each year [1]. The main risk factors are tobacco and alcohol use. In many developed countries, however, the majority of newly diagnosed tonsillar SCCs are associated with high-risk human papillomavirus (HPV) infection, predominantly HPV type 16 [2,3]. Compared to individuals with HPV negative tonsillar SCC, those with HPV positive disease have better prognosis, and they are often younger with no significant history of tobacco or alcohol use [4–6].

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