Researchers reported a 6.9 percent overall prevalence of oral HPV infection in the U.S. population in one of the most comprehensive studies of the virus to date, which took into account epidemiologic data, too. Also key: oral infection with HPV-16 was about three times more common in men than women, according to the study, reported at the Multidisciplinary Head and Neck Cancer Symposium (Abstract LBPL1) and published in the Journal of the American Medical Association ( 2012:307:693-703 ).
The meeting is sponsored by the American Head and Neck Society, the American Society of Clinical Oncology, the American Society for Radiation Oncology, and the Society of Nuclear Medicine.
Identifying populations at high-risk of HPV is becoming increasingly important since knowing it causes a subset of oropharyngeal squamous cell carcinoma, which has significantly increased over the last three years, according to the study.
“What we're seeing here is a cross-sectional picture of high-risk infections that are not screened for or treated,” said the lead author, Maura L. Gillison, MD, PhD, of Ohio State University Comprehensive Cancer Center, speaking at a news conference that highlighted three studies from the meeting. “This study is the first step toward the development of prevention and screening strategies for this type of HPV and cancer.”
The report found that men have a higher prevalence (10.1%) of oral HPV infection compared with women (3.6%). And, the findings showed that HPV prevalence “peaks” in two age categories: between ages 30 and 34 (7.3%), and between 60 and 64 (11.4%).
“It's very important that we consider the very strong link observed between sexual behavior and infection,” Gillison said. She and her colleagues found infection to be uncommon among sexually inexperienced individuals, eightfold higher among sexually experienced individuals, and increased significantly with number of sexual partners.
The researchers looked at some 5,500 male and female participants from the U.S. National Health and Nutrition Examination Survey (NHANES) between ages 14 and 69 to determine HPV prevalence using a 30-second oral rinse test—and compared the findings with independent factors including age, sex, lifetime number of sexual partners, and the number of cigarettes smoked per day.
Gillison said the next step is clinical trials to determine the effectiveness of the HPV vaccine in preventing HPV-positive oral squamous cell carcinoma, which could be used to recommend that at-risk populations get vaccinated.
“There are regions of the world in which HPV vaccination has been recognized as one of the most important leaps forward in cancer prevention,” she said. “We understand the Achilles heel of that cancer: If you don't get HPV infection, you don't get the cancer. There are very few other cancers for which we're going to be able to identify such necessary causes for targeted prevention.”