Single Men, Smokers at Higher Risk for Oral HPV Infection
Smokers and single men are more likely to acquire oncogenic oral human papillomavirus (HPV), according to new results from the HPV Infection in Men (HIM) Study. Researchers from Moffitt Cancer Center, the National Cancer Institute, Mexico, and Brazil also reported that newly acquired oral HPV infections in healthy men are rare and, when present, usually resolve within 1 year.
The study results appeared in the July issue of The Lancet.
Rates of HPV-related oropharyngeal cancer have been increasing rapidly, especially among men. To determine the pattern of HPV acquisition and persistence in the oral region, researchers evaluated the HPV infection status in oral mouthwash samples collected as part of the HIM Study, which was originally designed to evaluate the natural history of genital HPV infections in healthy men.
“Some types of HPV, such as HPV16, are known to cause cancer at multiple places in the body, including the oral cavity,” said study lead author Christine M. Pierce Campbell, PhD, MPH, a postdoctoral fellow in Moffitt’s Center for Infection Research in Cancer. “We know that HPV infection is associated with oropharyngeal cancer, but we don’t know how the virus progresses from initial infection to cancer in the oral cavity. One aspect of the HIM Study is to gather data to help us understand the natural history of these infections.”
Study Details
During the first 12 months, 4.4% of men in the study acquired an oral HPV infection, 0.6% of men in the study had an oral HPV16 infection (the most commonly acquired type), and 1.7% had an oral oncogenic HPV infection.
Median duration of infection was 6.9 months (95% confidence interval [CI] = 6.2–9.3; n = 45 cleared infections) for any HPV, 6.3 months (95% CI = 6.0–9.9 months; n = 18 cleared infections) for oncogenic HPV, and 7.3 months (95% CI = 6.0–not estimable; n = 5 cleared infections) for HPV16. Eight of the 18 incident oral HPV16 infections persisted for two or more study visits.
Their findings were consistent with previous studies showing a low prevalence of oral HPV cancers. However, this study shows the acquisition of oral oncogenic HPV appeared greater among smokers and unmarried men.
Additional Natural History Studies Needed
“Additional HPV natural history studies are needed to better inform the development of infection-related prevention efforts,” said Anna R. Giuliano, PhD, Director of Moffitt’s Center for Infection Research in Cancer. “HPV16 is associated with the rapid increase in incidence of oropharyngeal cancer, most noticeably in the United States, Sweden and Australia, where it is responsible for more than 50% of cases. Unfortunately, there are no proven methods to prevent or detect these cancers at an early stage.”
The researchers note that persistent oral HPV16 infection may be a precursor to oropharyngeal cancer, similar to how persistent cervical HPV infection leads to cervical precancer.
Funding for the study was provided by National Cancer Institute grants (CA R01CA098803, R25T CA147832) and the National Cancer Institute Intramural Research Program.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
