Journal of Vaccine Research, 2025, Vol.15, No.1, 23-33 http://medscipublisher.com/index.php/jvr 25 From the perspective of various regions, the number of oral cancers that have nothing to do with HPV is gradually decreasing. The number of people suffering from oral cancer and oropharyngeal cancer caused by HPV is increasing. This trend is particularly prominent among young people in North America, Europe, Asia and Oceania (Browwer et al., 2016). Take Brazil for example. The number of HPV-related oral cancer and oropharyngeal cancer cases among young patients has been increasing year by year, while the number of other oral cancer cases not caused by HPV has continued to decline (Menezes et al., 2020). These changes indicate that the incidence of oral cancer is changing, and the impact of HPV on the progression of the disease is also increasing. 3.2 Population risk factors Studies on the population have found that men are more prone to HPV-related oral cancer. The proportion of men infected with oral HPV and developing cancer is higher than that of women (D'Souza et al., 2017; Riddell et al., 2022). Age is also one of the key factors. Compared with oral cancer patients without HPV infection, patients with HPV infection tend to be diagnosed at a younger age, and the peak incidence is concentrated in the 60~64 age group (Mahal et al., 2019; Pirmoradi et al., 2024). Sexual behavior and smoking habits significantly increase the risk of oral carcinogenic HPV infection, especially for those who have multiple oral sexual partners and smoke for a long time (D 'Souza et al., 2017; Riddell et al., 2022). Data show that the proportion of men who smoke and have had five or more oral sexual partners infected with carcinogenic oral HPV is close to 15% (D'Souza et al., 2017). In addition, people with weakened immunity, such as AIDS patients, are more likely to be infected with oral HPV, and the virus is more difficult to clear, thereby increasing the risk of cancer (Beachler et al., 2011; Riddell et al., 2022). 3.3 HPV-positive and HPV-negative oral cancers There are significant differences in the causes of the disease and treatment outcomes between oral cancer patients infected with HPV and those not infected with HPV. Hpv-positive oral cancer is more common in young men and is usually associated with sexual behavior risks. Hpv-negative oral cancer is more often associated with traditional carcinogenic factors such as smoking and heavy drinking (Gillison et al., 2018; Pirmoradi et al., 2024). In terms of therapeutic efficacy, patients with HPV-positive oral cancer generally have milder conditions at the time of diagnosis, and the spread of cancer cells to lymph nodes is less common. Compared with HPV-negative patients, they have higher cure rates and recovery rates, and longer survival times (Mahal et al., 2019; Pirmoradi et al., 2024). These differences are of great significance for the selection of treatment plans and the prediction of the condition, and also indicate that it is very necessary to test for HPV infection when diagnosing oral cancer (Yete et al., 2017; Prakash et al., 2024). 4 Case Report: Clinical Insights 4.1 Common characteristics of reported cases In case reports of HPV-related oral cancer, it is often mentioned that the tumors grow at the bottom of the mouth, on the tongue and in the lower gums. Most patients develop squamous cell carcinoma (Rutkowska et al., 2020; Olmos et al., 2021). Among these cases, the most commonly detected virus type is HPV-16, followed by HPV-18, which also indicates that these two viruses are more likely to cause oral cancer. Many patients are diagnosed at an advanced stage of the disease. Quite a few are discovered at stage three or four of cancer, and the treatment effect is often not good. There is another common phenomenon in these cases, that is, patients do not pay attention to the symptoms until a long time after they appear. For instance, if there is a persistent ulcer in the mouth or a persistent lesion, but it usually does not cause pain at the beginning, it is very easy to be mistaken for a common minor problem . Due to the failure to seek medical treatment in a timely manner, the condition was severe when diagnosed. This also reminds us that both patients and doctors need to enhance their understanding of this disease (Rutkowska et al., 2020; Peter et al., 2023).
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