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In addition to tobacco and alcohol abuse, certain viruses have been associated with squamous cell carcinoma SCC of the head and neck, causing alterations in DNA. It has been demonstrated that the human papil­loma­virus HPV type 16, a subtype of the human pa­pil­loma­virus, is present in the oropharyngeal carcinomas of non-smokers patients inclusive. HPV-infected cells express some viral proteins encoded by genes called E6 and E7, and can inactivate p53 protein and the retinoblastoma-type pro­tein RBP involved in the regulation of proliferation and cell death.

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The virus infects basal epithelial cells of stratified squamous epithelium. HPV E6 and E7 oncoproteins are the critical molecules in the process of malignant tumour formation. Interacting with various cellular proteins, E6 and E7 influence fundamental cellular functions like cell cycle regulation, telomere maintenance, susceptibility to apoptosis, intercellular adhesion and regulation of immune responses.

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