Human papillomaviruses (HPVs) cause cancer at multiple anatomic sites in men and women, including cervical, oropharyngeal, anal, vulvar, and vaginal cancers in women and oropharyngeal, anal, and penile cancers in men. In this EUROGIN 2014 roadmap, differences in HPV-related cancer and infection burden by gender and anatomic site are reviewed. The proportion of cancers attributable to HPV varies by anatomic site, with nearly 100% of cervical, 88% of anal, and less than 50% of lower genital tract and oropharyngeal cancers attributable to HPV, depending on world region and prevalence of tobacco use. Often mirroring cancer incidence rates, HPV prevalence and infection natural history varies by gender and anatomic site of infection. Oral HPV infection is rare and significantly differs by gender; yet HPV-related cancer incidence at this site is several-fold higher than at either the anal canal or penile epithelium. HPV seroprevalence is significantly higher among women compared to men, likely explaining the differences in age-specific HPV prevalence and incidence patterns observed by gender. Correspondingly, among heterosexual partners, HPV transmission appears higher from women to men. More research is needed to characterize HPV natural history at each anatomic site where HPV causes cancer in men and women, information that is critical to inform the basic science of HPV natural history and the development of future infection and cancer prevention efforts.

Background: Oral human papillomavirus type-16 (HPV16) infection is a risk factor for oropharyngeal cancer. We examined oral HPV infection among healthy men.Methods: Oral rinse/gargle specimens and questionnaire data were collected from 1,688 healthy men aged 18 to 74 (median ¼ 31 years), from the United States, Mexico, and Brazil. HPV16,18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59, and noncarcinogenic HPV types were detected using Roche Linear Array.Results: Oral HPV DNA was detected in 67 of 1,680 (4.0%, 95% CI ¼ 3.1%-5.0%) b-globin-positive specimens; carcinogenic HPVs were detected in 1.3% (95% CI ¼ 0.8%-2.0%; n ¼ 22) and HPV16 was the most commonly detected carcinogenic HPV type (0.6%, 95% CI ¼ 0.2%-1.1%; n ¼ 10). The prevalence of oral HPV infection was similar by country except for HPV55, which had notably higher prevalence in Mexico (3.0%) than Brazil (0%) or the United States (0.2%). Oral HPV prevalence nonsignificantly increased over increasing age categories (P trend ¼ 0.096). The strongest predictor of oral HPV was current tobacco use, which increased the odds 2.5-fold (95% CI ¼ 1.4-4.4). Oral sexual behaviors were not associated with oral HPV infection.Conclusions: Oral HPV16 infection was rare in healthy men, especially at younger ages, and was positively associated with current tobacco use.Impact: Oral HPV appears to be about 10-fold less prevalent than infection at genital sites in men (4% vs. $40%, respectively). It remains unclear whether this reflects reduced exposure or if the oral region is more resistant to HPV infection compared with anogenital sites. Cancer Epidemiol Biomarkers Prev; 20(1); 172-82. Ó2011

Number of sex partners was associated with anal HPV infection in both MSW and MSM. Anal HPV infection in men may be mediated by age, duration of sexual relationship, and condom use.

Background Squamous cell carcinoma of the anus (SCCA) incidence is rising in the United States. Study of incidence trends by stage at diagnosis, age-specific and birth cohort patterns, and trends in mortality could provide evidence for a true increase and etiological clues for the increase in incidence. Methods Using the US Cancer Statistics dataset, we examined trends in SCCA incidence (2001–2015) and mortality (2001–2016) rates. Join-point regression was used to compute annual and average annual percentage change (AAPC). Incidence patterns by 5-year age group and birth cohort were evaluated using incidence rate ratios (IRRs) and age-period-cohort modeling. Results SCCA incidence increased 2.7% per year (95% confidence interval [CI] = 2.1% to 3.3%), with pronounced increases in age groups 50 years and older. Distant-stage SCCA incidence tripled (AAPC = 8.6%, 95% CI = 5.4% to 12.0%, among men and AAPC = 7.5%, 95% CI = 4.8% to 10.2%, among women) and regional-stage SCCA incidence nearly doubled (AAPC = 4.7% for men and women) in both sexes; the AAPC for localized stage was 1.3% (95% CI = 0.6% to 2.0%) in men and 2.3% (95% CI = 1.8% to 2.8%) in women. Compared with adults born circa 1946, recently born black men (born circa 1986) had a nearly fivefold higher risk (IRR = 4.7, 95% CI = 2.1 to 10.2) of SCCA, and the risk doubled among white men (IRR = 2.0, 95% CI = 1.7 to 2.2) and white women (IRR = 2.1, 95% CI = 1.9 to 2.3) born after circa 1960. Anal cancer mortality rates increased 3.1% per year (95% CI = 2.6% to 3.5%) with statistically significant increases in age groups 50 years and older. SCCA incidence-based mortality increased 1.9% annually (95% CI = 0.5% to 3.4%), with a notable (4.9%, 95% CI = 2.4% to 7.3%, per year) rise in adults ages 60–69 years. Conclusion The increase in SCCA incidence, particularly advanced-stage disease, and a similar increase in mortality suggest a true increase in the occurrence of SCCA. Future research and improved prevention are urgently needed to mitigate the increasing disease burden.

Although anal HPV infection is commonly acquired by both MSW and MSM, incident events and persistence occurred more often among MSM. Cigarette smoking is a modifiable risk factor that may contribute to HPV persistence among MSM.

Background: The burden of human papillomavirus (HPV) positive oropharyngeal squamous cell carcinoma (OPSCC) is disproportionately high among men, yet empirical evidence regarding the differential prevalence of oral HPV infection by gender is limited. Concordance of oral and genital HPV infection among men is unknown. Objective: To determine the prevalence of oral HPV infection, and concordance of oral and genital HPV infection among US men and women. Design: Nationally representative survey. Setting: Civilian noninstitutionalized population. Participants: Participants aged 18–69 years from the National Health and Nutritional Examination Survey (2011–2014). Measurements: Oral rinse, penile swab, and vaginal swab specimens were evaluated using polymerase chain reaction followed by type-specific hybridization. Results: The overall prevalence of oral HPV among men and women was 11.5% (equating to 11 million men nationwide) and 3.2% (3.2 million), respectively. High-risk oral HPV (HR-HPV) prevalence was higher among men (7.3%) than in women (1.4%). Oral HPV-16 was 6-times more common in men (1.8%) than in women (0.3%), i.e., 1.7 million men compared with 0.27 million women. Among men and women who reported having same gender sex partners, prevalence of HR-HPV infection was 12.7% and 3.6%, respectively. Particularly, among men who reported having ≥2 same gender oral sex partners, prevalence was 22.2%. Oral HPV prevalence among men with concurrent genital HPV infection was 4-fold greater (19.3%) compared to men without genital HPV infection (4.4%). Gender and lifetime number of oral sex partners were associated with overall HPV, HR-HPV, concordant overall HPV, and concordant HR-HPV infection. Limitations: Sexual behaviors were self-reported. Conclusion: Oral HPV infection is common among US men. Our findings provide several policy implications to guide future OPSCC prevention efforts to combat this disease.

Background While the primary cause of anal cancer is human papillomavirus (HPV) infection in the anal canal, little attention has been paid to the epidemiology of anal HPV in men having sex with women (MSW). Methods Anal canal exfoliated cells from 903 MSW in Brazil (São Paulo), Mexico (Cuernavaca) and the United States (Tampa) were tested for HPV DNA. Results HPV prevalence in the anal canal (12.0%) was similar in MSW in each city (P=0.77) while 7.0% had oncogenic types. Men in Tampa had a four–fold higher prevalence of HPV 16 than men in São Paulo or Cuernavaca (P<0.001). Duration of relationship with a primary sex partner and ever having oral or anal sex with a man was associated with any HPV type and any oncogenic type while lifetime number of female sex partners was associated with any HPV type. Conclusions Anal canal HPV is commonly found in MSW and the prevalence of HPV 16 may differ substantially by geography. Men with a larger number of female sex partners, in a sexual relationship of <1 year duration, and with a history of oral or anal sex with men were most likely to have an anal HPV infection.

No abstract