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Tonsillar Cancer: Incidence, Prevalence of HPV and Survival
Tonsillar Cancer: Incidence, Prevalence of HPV and Survival
has gained access to the market. The proposal is to vaccinate all females
between the age of 12 and 17 years of age. There are around 400 new cases of cervical
cancer in Sweden each year [19] and approximately 170 cases of tonsillar cancer and
50 cases of base of tongue cancer. In the two latter diseases there are 70 % men making
approximately 110 cases a year among men attributed to HPV. The majority, over 90
%, have consistently been shown to be HPV-16 positive [77, 78] which would make
100 cases among men attributable to HPV-16 and hence preventable with vaccination.
This, in line with the increasing trend of tonsillar and base of tongue cancer speaks in
favor of a debate regarding the value of vaccination for men as well.
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36
6 CONCLUSIONS
The main findings in this thesis were the following:
-the incidence of tonsillar cancer in Sweden has shown a remarkable increase between
1960-2003 while other smoking induced cancers have decreased
-the prevalence of HPV in tonsillar cancer has shown a parallel increase between 1970-
2002
-in the HPV-16 positive tumours, expression of E6/E7 was ascertained in the vast
majority and a better disease specific survival was noted for the HPV positive cases
-since 1960 there has been a significant increase in relative survival for patients with
tonsillar cancer in Sweden that can not be explained by earlier diagnosis
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7 ACKNOWLEDGEMENTS
Along the way I have had contact with many people without whom I could not have completed this
thesis.
First of all I would like to express my gratitude to my supervisor, Professor Eva Munck-Wikland,
without whom I would never even think of doing research. Along the journey I even started to find it
joyful. Whenever I have had doubts your positive way have always cheered me up.
My co-supervisor Docent Weimin Ye, for guiding me in the epidemiological jungle and for sharing your
vast knowledge.
My co-supervisor Professor Tina Dalianis, for your never ending source of enthusiasm, for your
inspirational way and for guiding me in the world of HPV and research.
To my Head of Department, Docent Richard Kuylenstierna, for paving way for my academical
education.
To Professor Dan Bagger-Sjbck and Professor Malou Hultcrantz for always being there for
questions.
To David Lindquist, my co-worker, for defending his thesis just ahead of me so I could learn from you
and for taking care of the lab issues.
My co-author Hanna Dahlstrand, who is always available when I have questions.
To Johan Lindholm, for great help with analyzing and a never ending source of enthusiasm.
To Dalianis lab group, for taking care of me when I am dropping by from time to another, Torbjrn,
Kalle, Mircea, Anders, Liselott, Lisa, Geraldine, Mathilda and Karin.
To those at MEB that have helped me along my journey, Yunxia Lu, Juhua Luo and Dariush Nesheli.
Professor Gert Auer and his group, Susanne Becker, Franz Bader and Uwe Roblick for their help and
knowledge in the proteomic field.
To all my wonderful friends and colleagues at the ENT clinic.
To all colleagues and teachers at Forskarskolan fr kliniker, for endless discussions during running
with Niclas and Evangelos.
To my friends Roger, Hasse, Martin, Johan, Johan, Tomas, Sten, Janne, Peter, Bea, Ami and Kalle
for encouraging me to work less.
To Caroline, for your love and support.
To my great family for putting up with my manners.
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