The prevalence of oropharyngeal cancers caused by the human papilloma virus (HPV) has increased in recent decades, with some groups much more likely than others to have the oral HPV infections that can cause these cancers. However, a study by Johns Hopkins Bloomberg School of Public Health researchers shows that the risk of developing HPV-related throat cancer remains generally low.
HPV is transmitted to the mouth and throat mostly through oral sex and appears to cause about 70% of oropharyngeal cancers. While there has been interest in the possibility of testing for oral HPV infection to identify people who are at high risk for HPV-related throat cancer, the research findings suggest that such testing is not justified at this time.
The Bloomberg School researchers analyzed behavioral and medical data on 13,089 adults from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014—data that included oral HPV tests. Oral infections with the dozen HPV types known to cause oropharyngeal cancer (especially HPV-16, the type that causes most throat cancers) were present at low prevalence in every defined group in the study.
Women ages 20 to 69, for example, had a frequency of infection of just over 1%, compared to 6% for men ages 20 to 69. Men ages 50 to 59 were most likely to have an infection (8.1%) of any age group. Smoking also was associated with higher oral HPV prevalence. The NHANES data showed that oral HPV-16 prevalence was very low on average in all groups, ranging from 0.1% in women ages 60 to 69 to 2.4% in men ages 60 to 69.
According to one researcher, mass screening for oral HPV infection is not advisable, because existing tests—for instance, of oral HPV-16 DNA—currently have more harms (from false positives) than benefits.
The study, “Understanding personal risk of oropharyngeal cancer: risk-groups for oncogenic oral HPV infection and oropharyngeal cancer,” was published by the Annals of Oncology.