Oral human papillomavirus (HPV) and associated factors among healthy populations: The design of the PROGRESS (PRevalence of Oral hpv infection, a Global aSSessment) study

Morais, Edith; Kothari, Smita; Roberts, C.S.; Yen, Glorian P.; Chen, Ya-Ting; Lynam, M. Judith; Pedrós, Montse; Mirghani, Haïtham; Alemany, Laia; Pavón, Miquel Ángel; Waterboer, Tim; Mehanna, Hisham; Giuliano, Anna R.

doi:10.1016/j.cct.2021.106630

Cited by 4 publications

(10 citation statements)

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“…Hopefully, ongoing studies will disentangle some of these uncertainties, but again this will take time [ 49 ]. Prevalence, incidence, and persistence of oral HPV in women and men, as well as the factors associated with oral infection, will be assessed in the PROGRESS study [ 50 ], whereas the main objective of the BROADEN study is to define the proportion of head and neck cancers attributable to HPV by anatomic site. [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

et al. 2022

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Head and neck cancer, the sixth most common cancer worldwide, account for about 1 out of 20 malignant tumors. In recent years a reduction in the incidence of cervical cancer, but a concomitant major increase in the incidence of HPV-mediated oropharyngeal cancer caused by orogenital HPV transmission has been observed. Consequently, in wealthy countries oropharyngeal squamous-cell carcinomas (OPSCC) is now the most frequent HPV-related cancer, having overtaken cervical cancer. Without effective medical interventions, this incidence trend could continue for decades. As no specific precursor lesion has been consistently identified in the oral cavity and oropharynx, HPV vaccination is the logical intervention to successfully counteract also the rising incidence of OPSCCs. However, HPV vaccine uptake remains suboptimal, particularly in males, the population at higher risk of OPSCC. Alternative primary prevention measures, such as modifications in sexual behaviors, could be implemented based on knowledge of individual genital HPV status. Until recently, this information was not available at a population level, but the current gradual shift from cytology (Pap test) to primary HPV testing for cervical cancer screening is revealing the presence of oncogenic viral genotypes in millions of women. In the past, health authorities and professional organizations have not consistently recommended modifications in sexual behaviors to be adopted when a persistent high-risk HPV cervicovaginal infection was identified. However, given the above changing epidemiologic scenario and the recent availability of an immense amount of novel information on genital HPV infection, it is unclear whether patient counseling should change. The right of future partners to be informed of the risk could also be considered. However, any modification of the provided counseling should be based also on the actual likelihood of a beneficial effect on the incidence of HPV-associated oropharyngeal cancers. The risk is on one side to induce unjustified anxiety and provide ineffective instructions, on the other side to miss the opportunity to limit the spread of oral HPV infections. Thus, major health authorities and international gynecologic scientific societies should issue or update specific recommendations, also with the aim of preventing inconsistent health care professionals’ behaviors.

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Section: Discussionmentioning

confidence: 99%

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

et al. 2022

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“…PROGRESS is a cross-sectional study assessing oral HPV infection in the US. A detailed description of the study design and methodology, including data collection, HPV testing procedures, and sample size calculations, has been published previously …”

Section: Methodsmentioning

confidence: 99%

“…Participating dental clinics used targeted sampling to recruit equal distributions of men and women and across age groups. 11…”

Section: Site Recruitment and Site Initiationmentioning

confidence: 99%

“…A detailed description of the study design and methodology, including data collection, HPV testing procedures, and sample size calculations, has been published previously. 11 Eligible participants were men and women aged 18 to 60 years accessing routine dental care who could provide written informed consent. All participants diagnosed with or who were suspected to have HNC were excluded.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…To fill gaps in knowledge, we designed the PROGRESS (Prevalence of Oral HPV Infection, a Global Assessment) study to assess oral HPV prevalence and associated factors in the general adult US population . Here we report the prevalence and oral HPV type distribution among men and women attending dental clinics for routine care in the US.…”

Section: Introductionmentioning

confidence: 99%

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Oral Human Papillomavirus Prevalence and Genotyping Among a Healthy Adult Population in the US

Giuliano

Felsher

Waterboer

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceIn the US, oropharyngeal cancer, predominantly caused by high-risk (HR) human papillomavirus (HPV) infection, is the most frequent HPV-associated cancer, surpassing cervical cancer. However, little is known about oral HPV prevalence and genotype distribution in the general population.ObjectiveTo assess oral HPV prevalence and factors associated with HR and low-risk infection in a general US population.Design, Setting, and ParticipantsPROGRESS (Prevalence of Oral HPV Infection, a Global Assessment) was a cross-sectional observational study conducted between November 2021 and March 2022 in 43 dental offices in the US (24 urban, 13 urban cluster, and 6 rural sites), spanning 21 states. Eligible participants were aged 18 to 60 years, visiting dental clinics for routine dental examination. Dental clinics used targeted sampling to recruit equal distributions of men and women and across age groups.ExposureParticipants provided an oral gargle specimen for HPV DNA and genotyping and completed behavioral questionnaires, and dentists reported oral health status. Detection of HPV DNA and genotyping was performed using the SPF10/DEIA/LiPA25 system at a central laboratory.Main OutcomeOral HPV prevalence.ResultsOf the 3196 participants enrolled, mean (SD) age was 39.6 (12.1) years, and 55.5% were women. Oral HPV prevalence was 6.6% (95% CI, 5.7%-7.4%) for any HPV genotype, and 2.0% (95% CI, 1.5%-2.5%), 0.7% (95% CI, 0.4%-1.0%), and 1.5% (95% CI, 1.1%-1.9%) for HR, HPV-16, and 9-valent-HPV vaccine types, respectively. Among HPV-positive participants, HPV-16 was the most prevalent genotype (12.4% among men and 8.6% among women). Prevalence of HPV was higher in men than women and highest among men aged 51 to 60 years (16.8%, 6.8%, and 2.1% for any HPV, HR HPV, and HPV-16, respectively). Factors associated with HR oral infection included being male (adjusted odds ratio [AOR], 3.1; 95% CI, 1.2-8.5), being aged 51 to 60 years (AOR, 3.3; 95% CI, 1.5-7.3), having 26 or more lifetime male sex partners (AOR, 6.5; 95% CI, 2.3-18.7), and having 6 to 25 lifetime female oral sex partners (AOR, 3.4; 95% CI, 1.3-8.7).Conclusions and RelevanceIn this cross-sectional study, oral HPV burden was highest among older men who may be at higher risk of developing oropharyngeal cancer. In addition to male sex and older age, HR oral HPV infection was also associated with sexual behaviors, including increasing number of male sex partners and female oral sex partners.

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The BROADEN study: The design of an observational study to assess the absolute burden of HPV-related head and neck cancers

Morais¹,

Kothari

Chen

et al. 2022

Contemporary Clinical Trials

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Oral human papillomavirus (HPV) and associated factors among healthy populations: The design of the PROGRESS (PRevalence of Oral hpv infection, a Global aSSessment) study

Cited by 4 publications

References 40 publications

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

Oral Human Papillomavirus Prevalence and Genotyping Among a Healthy Adult Population in the US

The BROADEN study: The design of an observational study to assess the absolute burden of HPV-related head and neck cancers

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