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Yet another study demonstrates that HPV-positivity (as determined by HPV RNA, in this case) portends favorable survival outcomes for squamous cell carcinomas (SCC)—but only of the oropharynx, not of another head and neck site nor of the cervix. This one goes a step further, though, to explain why. The authors describe an increased immune infiltration and immune modulation the can be observed in HPV+ oropharyngeal SCC as compared to HPV- oropharyngeal SCC and as compared to both HPV+ and HPV- SCC of other head and neck sites and the cervix. As a bonus, since they had HPV-RNA on every patient, they confirmed the postulation that p16-staining outside the oropharynx is not a great surrogate for HPV: while p16- tumors were HPV-, p16+ tumors could go either way. | Zhu, JAMA Otolaryngol Head Neck Surg 2021