Incidence of high-risk oral HPV increasing

About 7% of Americans are infected with oral human papillomavirus (HPV), according to a recent cross-sectional study. Prevalence is almost 3 times higher in men than in women, about 8 times higher in those who are sexually active than in those who are not, and variably higher among cigarette smokers, former and current marijuana users, and heavy alcohol drinkers.

Data was assessed from 5,579 men and women aged 14 to 69 years who were participating in the National Health and Nutrition Examination Survey (NHANES) 2009-2010, which is a statistically representative sample of the civilian noninstitutionalized US population. Participants were given a 30-second oral rinse, gargled with mouthwash, after which researchers assessed DNA purified from oral exfoliated cells.

Overall prevalence of oral HPV in the study group was 6.9% (95% confidence interval [CI], 5.7%-8.3%). The most prevalent type of HPV detected was HPV-16 with a 1.0% overall prevalence rate. Men were more than 5 times as likely as women to be infected with HPV-16 and had a higher incidence of HPV-positive oral squamous cell carcinomas (OSCCs).

Sixty- to 64-year-old participants had the highest incidence (11.4%; 95% CI, 8.5%-15.1%), followed by 30- to 34-year-olds (7.3%; 95% CI, 4.6%-11.4%). The prevalence rate among men was 10.1% (95% CI, 8.3%-12.3%) versus 3.6% in women (95% CI, 2.6%-5.0%). Incidence among those with no history of sexual activity was 0.9% (95% CI, 0.4%-1.8%) versus 7.5% (95% CI, 6.1%-9.1%) among those who are sexually active.

Prevalence increased with number of sexual partners: 20% of those with more than 20 lifetime sexual partners were infected, and it also was higher among those who first performed oral sex at 18 years of age or younger.

Gillison ML, Broutian T, Pickard RK, et al. Prevalence of oral HPV infection in the United States, 2009-2010. JAMA. 2012;307(7):693-703.