Case–Control Study of Human Papillomavirus and Oropharyngeal Cancer

• Published in: The New England journal of medicine Vol. 356; no. 19; pp. 1944 - 1956
• Main Authors: D'Souza, Gypsyamber, Kreimer, Aimee R, Viscidi, Raphael, Pawlita, Michael, Fakhry, Carole, Koch, Wayne M, Westra, William H, Gillison, Maura L
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 10.05.2007
• Subjects: Aged; Alcohol Drinking - adverse effects; Alcohol Drinking - epidemiology; Alphapapillomavirus - isolation & purification; Antibodies, Viral - blood; Behavior; Biological and medical sciences; Cancer; Carcinoma, Squamous Cell - etiology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - virology; Case-Control Studies; Deoxyribonucleic acid; DNA; DNA, Viral - isolation & purification; Epidemiology; Family medical history; Female; General aspects; Human papillomavirus; Human papillomavirus 16 - genetics; Human papillomavirus 16 - immunology; Human papillomavirus 16 - isolation & purification; Humans; In Situ Hybridization; Infections; Logistic Models; Male; Medical sciences; Middle Aged; Mouth - virology; Multivariate Analysis; Oral Hygiene; Oropharyngeal Neoplasms - etiology; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - virology; Papillomavirus Infections - complications; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Sexual Behavior; Smoking - adverse effects; Smoking - epidemiology; Oropharynx cancer; Papovaviridae; Malignant tumor; Case control study; Epidemiology; Infection; Papillomavirus; Virus; Medicine; Human papillomavirus; Viral disease; ENT disease; Pharynx disease; Public health
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa065497

This study offers persuasive evidence of a strong association between exposure to or oral infection with the human papillomavirus and oropharyngeal cancer. The data indicate that sexual behaviors can spread the virus to the oral cavity. The use of tobacco, alcohol, or both did not strengthen the association between exposure to HPV and oropharyngeal cancer. Among patients who had no evidence of exposure to HPV, however, tobacco and alcohol use were strongly associated with oropharyngeal cancer. This study offers persuasive evidence of a strong association between exposure to or oral infection with HPV and oropharyngeal cancer. The use of tobacco, alcohol, or both did not strengthen the association between exposure to HPV and oropharyngeal cancer. Infection with sexually transmitted human papillomavirus (HPV) is a cause of virtually all cervical cancers. 1 Molecular evidence also provides support for a role for HPV, particularly HPV-16, in the pathogenesis of a subgroup of squamous-cell carcinomas of the head and neck. 2 Genomic DNA of oncogenic HPV is detected in approximately 26% of all squamous-cell carcinomas of the head and neck worldwide, 3 but the molecular evidence is most rigorous and consistent for oropharyngeal squamous-cell carcinoma, in which viral integration and the expression of viral oncogenes (E6 and E7) have been shown. 4 The epidemiologic evidence of a causal role for HPV in . . .