I'm going to close this thread up and we can start another one about the subset populations. Clearly the HPV issue is important, particularly in the light of early detection, as we can no longer determine who is the high risk patient, and worthy of screening. That is the most important part of the research findings. I have had for several months Gillison's next article which will be in the New England Journal of Medicine next month and it covers the demographics of this subset population. The rate of growth of the HPV subset has been between 2-3% a year from the early 70's, and shows no sign of slowing down. While as patients we all tend to think about recurrence rates, survival, and possible changes in treatment, the real issue here is early detection and how that impacts catching this before it becomes a killer stage disease. It also puts another emphasis on the pre-sex vaccine - as the positive collateral benefits from the cervical vaccine in the head and neck community will clearly be evident a decade or more from now as it becomes less of a factor in the etiology of the oral cancer world.