Oral HPV infection affects 7% of population, more men than women

The overall prevalence of oral human papillomavirus (HPV) infection was nearly 7% among men and women ages 14 to 69 years in the United States, and was higher among men than among women, a study found.

A cross-sectional study was conducted as part of the National Health and Nutrition Examination Survey (NHANES) 2009-2010. Participants (n=5,579) performed a 30-second oral rinse and gargle with mouthwash at mobile testing centers. HPV types were detected through DNA via polymerase chain reaction tests. Demographics were obtained through questionnaires. Results appeared in the Jan. 26 Journal of the American Medical Association.

The prevalence of oral HPV infection was 6.9% (95% CI, 5.7% to 8.3%). The most prevalent type was HPV type 16, at 1% (95% CI, 0.7% to 1.3%), which indicates an estimated 2.13 million infected individuals in the U.S. Oral HPV infection had two peak prevalence periods by age, first among individuals ages 30 to 34 years (7.3%; 95% CI, 4.6% to 11.4%) and second among those ages 60 to 64 years (11.4%; 95% CI, 8.5% to 15.1%).

Men had a significantly higher prevalence than women of any oral HPV infection (10.1% [95% CI, 8.3% to 12.3%] compared to 3.6% [95% CI, 2.6% to 5.0%], P<0.001; unadjusted prevalence ratio [PR], 2.80 [95% CI, 2.02 to 3.88]).

Infection was less common among those without a history of any type of sexual contact compared to those with (0.9% [95% CI, 0.4% to 1.8%] vs. 7.5% [95% CI, 6.1% to 9.1%], P<0.001; PR, 8.69 [95% CI, 3.91 to 19.31]), and risk increased with number of sexual partners (P<0.001 for trend) and cigarettes smoked per day (P<0.001 for trend).

The authors wrote, “[V]accine efficacy against oral HPV infection is unknown, and therefore vaccination cannot currently be recommended for the primary prevention of oropharyngeal cancer. Given an analysis of U.S. cancer registry data recently projected that the number of HPV-positive oropharyngeal cancers diagnosed each year will surpass that of invasive cervical cancers by the year 2020, perhaps such vaccine trials are warranted.”

An editorial commented that “[C]linicians should encourage their patients who engage in oral sex to use barrier protection. Physicians should also be vigilant for the signs and symptoms of oropharyngeal cancer, such as persistent odynophagia, dysphagia, dysphonia, otalgia, a feeling of globus, a neck mass, or unexplained weight loss, and perform a thorough head and neck evaluation if present.”