Abstract
The natural history of oral human papillomavirus (HPV) infection which is linked with the increased incidence of oropharyngeal squamous cell cancer (OPSCC) has been incompletely studied. Oral swab specimens and questionnaire data were obtained bi-annually for up to 6 visits from 4314 healthy adults aged 25-69 in rural Anyang, China. HPV infection status was evaluated with PCR-based sequencing. Participants with at least two consecutive valid HPV results within the study period were included in the incidence and clearance analysis. Among 3289 participants included in this analysis (median follow-up time 18.3 months), incidence rates of mucosal HPV, oncogenic mucosal HPV and cutaneous HPV were 0.53 (95% CI: 0.39-0.73), 0.30 (95% CI: 0.20-0.46), and 4.17 (95% CI: 3.70-4.70) per 1,000 person-months respectively. Most newly acquired infections were cleared within one year. Recent practice of oral sex increased the risk of incident infection with mucosal HPV (Adjusted HR, 5.03; 95% CI, 1.16-21.73) and oncogenic mucosal HPV (Adjusted HR, 10.13; 95% CI, 2.14-48.06). Newly acquired oral mucosal HPV infections are rare and most are cleared within one year in rural Chinese. This study expands understanding of the natural history of oral HPV in countries with a lower incidence of HPV-OPSCC.
Highlights
Oral human papillomavirus (HPV) infection is linked with the rapid increase in incidence of oropharyngeal squamous cell cancer (OPSCC) for which there is no demonstrably effective methods of prevention in some developed regions of the world [1]
Data from this study demonstrates that acquisition of oral mucosal HPV infection is a rare event, and most incident infections are cleared within one year in rural China
The incidence rate of mucosal HPV infection is similar across gender and age groups
Summary
Oral human papillomavirus (HPV) infection (primarily HPV-16) is linked with the rapid increase in incidence of oropharyngeal squamous cell cancer (OPSCC) for which there is no demonstrably effective methods of prevention in some developed regions of the world [1]. Undertaken mainly in developed areas, have shown that oral HPV infection appears to have a low incidence rate and a high clearance rate [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20]. We reported an overall oral mucosal HPV prevalence of 0.67% in 5410 individuals aged 2565 years in rural China [21] This current prospective cohort study was conducted to investigate the incidence and clearance of oral HPV infection, and evaluate www.impactjournals.com/oncotarget potential risk factors for this infection in the same general unvaccinated population
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