Study Examines Link between HPV and Risk of Head and Neck Cancers

New York, USA – Researchers at the Albert Einstein College of Medicine have found that when human papillomavirus (HPV)-16 is detected in peoples’ mouths, they are 22 times more likely than those without HPV-16 to develop a type of head and neck cancer. The study was published online today in JAMA Oncology and was led by Ilir Agalliu, MD, ScD, and Robert D. Burk, MD.

HPV-16 is a well-known cause of head and neck cancers. A rising proportion of these cancers are oropharyngeal cancers (cancers of the middle part of the throat including the soft palate, the base of the tongue and the tonsils). This study is the first to demonstrate conclusively that HPV-16’s presence in the oral cavity precedes the development of oropharyngeal cancers. (HPV-16 is also responsible for the majority of cervical cancers.) Other studies indicate that detection of HPV in the oral cavity is related to sexual behaviour.

The Einstein study involved nearly 97,000 people taking part in two large, national prospective studies. At the start of the studies, participants provided mouthwash samples and were cancer-free. A total of 132 cases of head and neck cancer were identified during an average of nearly four years of follow-up. The study also included a comparison group of 396 healthy subjects (controls), i.e., three controls for each case. Mouthwash samples for head-and-neck cancer cases and for the controls were analysed for the presence of several types of oral HPVs.

People with HPV-16 in their mouthwash samples were 22 times more likely to develop oropharyngeal cancer than were study participants with no detectable HPV-16 in their samples, the researchers found. In addition, the researchers found for the first time that the presence of other types of oral HPVs – beta- and gamma-HPVs, which are usually detected in the skin – was also associated with the development of head and neck cancers, indicating a broader role for HPVs in causing these cancers than has been recognised to date. This study shows that using easily collected oral mouthwash samples may help in predicting people’s risk for developing head and neck cancers.

Dr. Agalliu is assistant professor of epidemiology and population health and Dr. Burk is professor of paediatrics; microbiology & immunology; obstetrics & gynaecology and women’s health; and epidemiology & population health at Einstein and attending physician, paediatrics at Montefiore Health System. Drs. Agalliu and Burk are also members of the NCI-designated Albert Einstein Cancer Centre’s Cancer Epidemiology programme.

In addition to Drs. Agalliu and Burk, other Einstein authors are Tao Wang, PhD, and Zigui Chen, PhD. Additional authors are Susan Gapstur, PhD, Rebecca L. Anderson, MPH, and Lauren Teras, PhD, at the American Cancer Society, Atlanta, GA; Aimee R. Kreimer, PhD and Neal D. Freedman, PhD at the National Cancer Institute, National Institutes of Health, Bethesda, MD; and Richard B. Hayes, PhD, at New York University, New York.

This study was supported by public funds through a grant to Drs. Agalliu and Burk from the National Institutes of Health (R21-CA152785-2 and P30-CA013330). The authors report no conflicts of interest.