Oral HPV Infections May Explain Why Some Head and Neck Cancers are More Common in Men ► NCI Cancer Bulletin for February 7, 2012 - National Cancer Institute

NCI Cancer Bulletin for February 7, 2012 - National Cancer Institute

Oral HPV Infections May Explain Why Some Head and Neck Cancers are More Common in Men

The prevalence of human papillomavirus (HPV) infections in the oral cavity is significantly higher among men than women in the United States, according to a new study from researchers at Ohio State University and NCI’s Division of Cancer Epidemiology and Genetics (DCEG). Oral HPV infections have been associated with oropharyngeal cancer—a subset of head and neck cancers that arise in the back of the tongue, throat, and tonsils—rates of which have risen dramatically over the last several decades.

The study is the first to comprehensively document the prevalence of oral HPV infections in men and women in the United States. Overall, approximately 7 percent of people between the ages of 14 and 69 have an oral HPV infection, reported lead investigator Dr. Maura Gillison last week at the Multidisciplinary Head and Neck Cancer Symposium . (The prevalence of oral infections, however, is much lower than that of infections in the genital tract.) About 1 percent of the population has an oral infection with HPV 16, a type that is linked to cancer. The results were also published online January 26 in JAMA.

Using data from the National Health and Nutrition Examination Survey (NHANES), the researchers studied nearly 5,600 men and women ages 14 to 69, who provided an oral rinse and mouthwash gargle samples. The most common subtype of HPV in the oral cells of study participants was HPV 16, the HPV type that is responsible for more than half of all oropharyngeal cancer cases.

Oral HPV infections were three times more common in men than in women (10.1 percent versus 3.6 percent), with older men having the highest rates, Dr. Gillison said during a press briefing. Oral infections with HPV 16 were seen in 1.6 percent of men and 0.3 percent of women. The prevalence of HPV infections was highest among people who smoke at least a pack a day and those with more than 20 lifetime sexual partners.
HPV-related head and neck cancers are far more common among men than women, Dr. Gillison said. The higher oral HPV infection rates in men, “in particular the over fivefold higher prevalence of HPV 16 among men compared to women,” likely explains the discrepancy, she said.

As for why men are more likely to be infected, the available data, she said, “suggest that men are more prone to getting [HPV] infections…or, once infected, are more likely to have the infection persist.” It could also be a combination of both factors, she continued.

“These findings are particularly relevant because, in contrast to other head and neck cancers, HPV-associated oropharyngeal cancer rates have been on the rise in recent years,” commented senior author Dr. Anil Chaturvedi of DCEG’s Infections and Immunoepidemiology Branch. “The higher prevalence of both cigarette smoking and oral HPV infection in men helps complete our understanding of why men have higher rates of oropharyngeal cancer than women.”

See also: “Rising Oropharyngeal Cancer Rates Linked to HPV Infection”