_applied_  
_sciences_  
_Article_  
Emerging Oncogenic Viruses in Head and Neck Cancers from Romanian Patients  
**[PERSON] \({}^{1}\)\({}^{\copyright}\)**, [PERSON] \({}^{2,*}\)\({}^{\copyright}\), [PERSON] \({}^{3,*}\)\({}^{\copyright}\), [PERSON] \({}^{4}\)\({}^{\copyright}\), [PERSON] \({}^{4}\), [PERSON] \({}^{5}\)\({}^{\copyright}\), [PERSON] \({}^{1,*}\), [PERSON] \({}^{1,\dagger}\)\({}^{\copyright}\) and [PERSON] \({}^{6}\) \begin{tabular}{p{34.1 pt}}
1 Discipline of Microbiology, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [EMAIL_ADDRESS] (R.G.U.); [EMAIL_ADDRESS] (L.S.I.) \\
2 Department of Periodontology, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania \\
3 Department of Plastic Surgery, Regional Oncology Institute, 700483 Iasi, Romania \\
4 Discipline of Oro-Maxillo-Facial Surgery, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [PERSON]S] (V.C.); [PERSON] (O.S.) \\
5 Department of ENT, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [PERSON] \\
6 Department of Dermatology, \"[PERSON]\" Clinical Emergency County Hospital, 700111 Iasi, Romania; [PERSON]S] \\
* Correspondence: [EMAIL_ADDRESS] (L.L.); [EMAIL_ADDRESS] (N.G.); [EMAIL_ADDRESS] (C.D.) \\ \(\dagger\) Author with equal contribution as the first author. \\ \end{tabular}   
**Abstract: (1) Background: Head and neck squamous cell carcinomas (HNSCCs) are some of the most frequent malignancies globally. Oncogenic viruses MCPyV, EBV and HPVs are recognized to be related to HNSCC and skin cancers. There are no data from Romania regarding the involvement of herpes viruses and polyomaviruses in these types of cancer. We aim to evaluate the association of oncogenic viruses from _Papillonaviridae, Herpesaviridae,_ and _Polymeritidae_ families in HNSCCs and skin cancers. (2) Methods: A total of 26 fresh tumors (6/26 women) were tested for 67 viral agents using a multiplex PCR genotyping assay. (3) Results: A total of 23/26 (88.5%) samples were positive for one or more viruses. All the tested tumors were negative for any HPV (alpha or beta types). In total, we detected as positive samples: 16 (61.63%) EBV1, 12 (46.15%) HHV7, 8 (30.76%) MCV, 6 (23.07%) CMV and HHV6, 2 (7.69%) HHV8, 1 (3.8%) HPVV6 and EBV2. (4) Conclusions: We detected HPV-negative cases that are HPVV and HHV positive. In these fractions of HPV-negative HNSCCs cases, other oncogenic viruses may be involved, such as EBV1, MCV or CMV. Additional research is required for clarifying the natural history of these viruses in HNSCCs, as virus detection would have a decisive impact on diagnostic and decisional algorithms. **  
**Keywords:** oncogenic virus; criteria for carcinogenicity; screening; clinical utility  
**1. Introduction**  
Cancer cases are one of the most important cause of death in the EU, with 3.5 million new cases diagnosed each year, leading to 1.3 million deaths. The current estimation is that, up to 2035, incidence will increase by 24%, up to 40% for cancer cases which could be prevented [1]. Romania has a high burden of cancer. The estimated age-standardized incidence rates in 2020, for hypopharynx, larynx, lip, oral cavity, both sexes, all ages in Romania were 13.0 ASR, being the third highest in Europe, and for non-melanoma skin cancer was 7.3 ASR (World), in 25 th place in Europe [2, 3, 4]. These updated data, which are available on the International Agency for Research on Cancer (IARC)--Global Cancer Registry underline the importance of these two categories of cancers in our country. The carcinogenic role of some viruses has been well stated by IARC monographs: Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) have a well-established role in liver carcinogenesis, Epstein-Barr Virus (EBV) is known to be responsible for Burkittlymphoma in parallel with some co-factors, high risk types of HPV (mainly 16, 18, 31, 33, 45, 52) are associated with cervical cancer. Additionally, HPV16 was recognized for having an important role in the carcinogenicity of oropharyngeal cancers [5].