National Cancer Institute

Prevalidation of Salivary Biomarkers for Oral Cancer Detection

Source: AACRJournals.org

Abstract

Background: Oral cancer is the sixth most common cancer with a 5-year survival rate of approximately 60%. Presently, there are no scientifically credible early detection techniques beyond conventional clinical oral examination. The goal of this study is to validate whether the seven mRNAs and three proteins previously reported as biomarkers are capable of discriminating patients with oral squamous cell carcinomas (OSCC) from healthy subjects in independent cohorts and by a National Cancer Institute (NCI)-Early Detection Research Network (EDRN)-Biomarker Reference Laboratory (BRL).

Methods: Three hundred and ninety-five subjects from five independent cohorts based on case controlled design were investigated by two independent laboratories, University of California, Los Angeles (Los Angeles, CA) discovery laboratory and NCI-EDRN-BRL.

Results: Expression of all seven mRNA and three protein markers was increased in OSCC versus controls in all five cohorts. With respect to individual marker performance across the five cohorts, the increase in interleukin (IL)-8 and subcutaneous adipose tissue (SAT) was statistically significant and they remained top performers across different cohorts in terms of sensitivity and specificity. A previously identified multiple marker model showed an area under the receiver operating characteristic (ROC) curve for prediction of OSCC status ranging from 0.74 to 0.86 across the cohorts.

Conclusions: The validation of these biomarkers showed their feasibility in the discrimination of OSCCs from healthy controls. Established assay technologies are robust enough to perform independently. Individual cutoff values for each of these markers and for the combined predictive model need to be further defined in large clinical studies.

Impact: Salivary proteomic and transcriptomic biomarkers can discriminate oral cancer from control subjects. Cancer Epidemiol Biomarkers Prev; 21(4); 664–72. ©2012 AACR.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

March, 2012|Oral Cancer News|

Maura L. Gillison, M.D., Ph.D., Receives AACR’s Richard and Hinda Rosenthal Memorial Award

Source: AACR News

CHICAGO — The American Association for Cancer Research will award Maura L. Gillison, M.D., Ph.D., with the 36th Annual AACR Richard and Hinda Rosenthal Memorial Award during the AACR Annual Meeting 2012, held here March 31 – April 4. Gillison is receiving this award in recognition of her significant contributions to the understanding of the role of human papillomavirus (HPV) in head and neck cancers.

Gillison’s award lecture, “Clinical implications of HPV in head and neck cancers,” will take place at 10 a.m. CT on Wednesday, April 4 in room S100 of the McCormick Place Convention Center.

“It is an honor to be the recipient of this award,” said Gillison. “Our team strives to generate data that will improve the lives of individuals affected by head and neck cancers, and this is a wonderful validation that we are on the right track.”

This award is designed to provide incentive to young investigators early in their careers. It was established in 1977 by the AACR and the Rosenthal Family Foundation to recognize research that has made, or promises to make, a notable contribution to improved clinical care in the field of cancer.

Gillison is a professor of medicine, epidemiology and otolaryngology and the Jeg Coughlin Chair of Cancer Research at Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, Ohio. She is also adjunct faculty at The Johns Hopkins University School of Medicine, in Baltimore, Md. Her seminal research on the role of HPV in head and neck cancers revolutionized the specialty. Her research has demonstrated that HPV infection causes a distinct molecular, clinical and pathological subset of head and neck squamous cell carcinomas.

In a landmark case-control study, Gillison identified oral sexual behavior and HPV infection as risk factors for oropharyngeal cancer, findings that led the International Agency for Research on Cancer to formally recognize HPV-16 as a significant cause of oropharyngeal cancers.

Results of other key studies conducted by Gillison and her colleagues showed that tumor HPV status is one of the single greatest predictors of survival in head and neck cancer. As a result, multiple organizations now advocate routine HPV testing of oropharyngeal cancer patients. Clinical trial designs have also been amended to adopt HPV testing as a means by which to stratify various cancer subsets, allowing for better targeted therapies and treatment regimens. Additionally, Gillison established the gold standard of HPV diagnostic tests, currently in use within clinics nationwide. Currently, she is the principal investigator of the first phase III trial focused on HPV-positive head and neck cancers, which began enrolling patients in 2011.

Gillison has led several studies in collaboration with the National Cancer Institute and the Centers for Disease Control and Prevention that have examined the effects of HPV infection on head and neck cancer at the population level. She has also been the leader in development of methods for oral HPV detection, which will facilitate the development of primary and secondary prevention strategies for the cancer she characterized.

Gillison’s work has had, and will continue to have, significant public health implications. Her group’s recent research established that HPV has been the cause of a dramatic increase in the incidence of oropharyngeal cancer in the United States during the last 20 years.

Currently, the burden of HPV-caused cancers is shifting from women to men, a trend that is anticipated to continue throughout the next decade. In 2011, such data were presented to the Advisory Committee on Immunization Practices, which now recommends that all preteen boys aged 11 to 12 be vaccinated against HPV.

About the AACR

Founded in 1907, the American Association for Cancer Research (AACR) is the world’s first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR’s membership includes 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 18,000 attendees. In addition, the AACR publishes seven peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the Scientific Partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of individual and team science grants in cancer research that have the potential for patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

March, 2012|Oral Cancer News|

Nearly 800,000 Deaths Prevented Due to Declines in Smoking

Source: National Cancer Institute

Twentieth-century tobacco control programs and policies were responsible for preventing more than 795,000 lung cancer deaths in the United States from 1975 through 2000, according to an analysis funded by the National Cancer Institute (NCI), part of the National Institutes of Health.

In this Black & White photo, the U.S. Surgeon General, Luther Terry, is standing at a podium, addressing a non-pictured audience.  Two rows of men are seated in folding chairs behind him.

If all cigarette smoking in this country had ceased following the release of the first Surgeon General’s report on smoking and health in 1964, a total of 2.5 million people would have been spared from death due to lung cancer in the 36 years following that report, according to the analysis.  The results of this study were published online March 14, 2012, in the Journal of the National Cancer Institute.

“These findings provide a compelling illustration of the devastating impact of tobacco use in our nation and the enormous benefits of reducing rates of smoking,” said Robert Croyle, Ph.D., director of the Division of Cancer Control and Population Sciences at NCI.  “Although great strides have been made, we cannot relax our efforts.  The prevention and cessation of tobacco use continue to be vital priorities for the medical, scientific, and public health communities.”

The researchers, part of the NCI-sponsored Cancer Intervention and Surveillance Modeling Network (CISNET), utilized a comparative modeling approach in which they constructed detailed cigarette smoking histories for individuals born from 1890 through 1970, and then related the histories to lung cancer mortality in mathematical models.  Using these models, the researchers were able to estimate the impact of changes in smoking patterns resulting from tobacco control activities on lung cancer deaths during the period from 1975 through 2000.  Since the 1964 report, tobacco control efforts in the United States have included restrictions on smoking in public places, increases in cigarette excise taxes, limits on underage access to cigarettes, and efforts to increase public awareness of the hazards of smoking.

“This is the first attempt to quantify the impact of changes in smoking behaviors on lung cancer mortality based on detailed reconstruction of cigarette smoking histories,” said lead author Suresh Moolgavkar, M.D., Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle.  “The methods that were developed as a part of this research should prove to be invaluable to other researchers investigating the adverse health impacts of cigarette smoking.”

This line chart plots lung cancer death rates from 1975-2000, under the three scenarios studied by the researchers; i.e., No Tobacco Control, Actual Tobacco Control, and Complete Tobacco Control. This chart provides data for U.S. Men.

In the study, the researchers created three scenarios.  In the first, called actual tobacco control, they used data on actual smoking behaviors of men and women in the United States.  The second, called no tobacco control, predicted smoking behaviors that would have existed if no tobacco control policies were put in place.  In the third, called complete tobacco control, the researchers examined the possible outcome if all smoking in the United States had ceased as of 1965, the first full year after the 1964 Surgeon General’s Report on Smoking and Health was released.

The difference between lung cancer deaths in the no tobacco control scenario and the numbers of actual lung cancer deaths provided an estimate of the numbers of lung cancer deaths averted as a result of tobacco control activities.  This difference is graphically represented in two charts accompanying this release, based on data from Yale University, which created one of the models used in this analysis.  The researchers estimated that, without tobacco control programs and policies, an additional 552,000 men and 243,000 women would have died of lung cancer in the period from 1975 through 2000.

This line chart plots lung cancer death rates from 1975-2000, under the three scenarios studied by the researchers; i.e., No Tobacco Control, Actual Tobacco Control, and Complete Tobacco Control. This chart provides data for U.S. Women.

Similarly, the difference between the no tobacco control scenario and the complete tobacco control scenario provides an estimate of the lung cancer deaths that could have been avoided if everyone who smoked quit in 1965 and no one started smoking.  If tobacco control efforts had been completely successful, an additional 1.7 million lung cancer deaths would have been averted from 1975 through 2000.  In total, if all smoking had ceased completely in 1965, as many as 2.5 million fewer people would have died from lung cancer (1.6 million men and 883,000 women).

“An overwhelming majority of lung cancer deaths can be prevented by eliminating cigarette smoking,” said study author Eric Feuer, Ph.D., chief of NCI’s Statistical Methodology and Applications Branch.  “The progress that has been made by tobacco control programs and policies in reducing lung cancer deaths represents about a third of the progress that could have been made if all cigarette smoking had ceased in 1965.  This finding indicates that, while great strides have been made in tobacco control – averting hundreds of thousands of lung cancer deaths in the United States – continued and enhanced efforts have the potential to avert even more deaths.”

The researchers estimations only run through the year 2000 because, for more recent years, sufficiently detailed data were unavailable when the project began.  However, it can be inferred that additional lung cancer deaths have been averted since the year 2000, because according to previous research, smoking rates among U.S. adults have continued to fall, dropping from 23.2 percent in 2000 to 20.6 percent in 2008, and leveling off in recent years.  Previous research indicates that much of the decrease in smoking rates can be attributed to tobacco control policies.  In addition, although beyond the scope of the journal article, rates of other smoking related cancers, and smoking-related diseases, such as cardiovascular and respiratory diseases, have declined due to tobacco control programs and policies.

In 2011, researchers conducting the National Lung Screening Trial (NLST) found that screening heavy smokers with low-dose spiral CT reduced lung cancer mortality by 20 percent, compared to standard chest X-ray (for more information, see the press release on this study).  Even with the potential mortality benefits associated with screening, continued implementation of evidence-based tobacco control policies, programs, and services remains a critical approach to reducing the burden of lung cancer, according to the authors.

CISNET is a consortium of NCI-sponsored investigators who use statistical modeling to improve our understanding of cancer control interventions in prevention, screening, and treatment.  This modeling approach, which has been validated in several previous studies, can be used to guide public health research and priorities.  The network is working on a project to study the efficacy of lung cancer screening for smokers in different age and exposure level groups, based on the results of benefit for spiral CT screening found in the NLST for heavy smokers.

The results discussed in the paper are based on six different models, developed by members of the CISNET network.  The centers that created these models include Erasmus Medical Center, The Netherlands; Fred Hutchinson Cancer Research Center, Seattle; Pacific Institute for Research and Evaluation, Calverton, Md.; Rice University-M.D. Anderson Cancer Center, Houston; Massachusetts General Hospital-Harvard Medical School, Boston; and Yale University, New Haven, Conn.  More details about the construction of models will be published in a forthcoming special issue of Risk Analysis – An International Journal.

Click here to view the Youtube video, Using Statistical Modeling to Evaluate Tobacco Control Efforts: http://www.youtube.com/watch?v=yjQNFgpOhhA

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

March, 2012|Oral Cancer News|

Red Meat Consumption Linked to Increased Risk of Total, Cardiovascular, and Cancer Mortality

Source: Harvard School of Public Health

Boston, MA — A new study from Harvard School of Public Health (HSPH) researchers has found that red meat consumption is associated with an increased risk of total, cardiovascular, and cancer mortality. The results also showed that substituting other healthy protein sources, such as fish, poultry, nuts, and legumes, was associated with a lower risk of mortality.

The study will be published online in Archives of Internal Medicine on March 12, 2012.

“Our study adds more evidence to the health risks of eating high amounts of red meat, which has been associated with type 2 diabetes, coronary heart disease, stroke, and certain cancers in other studies,” said lead author An Pan, research fellow in the Department of Nutrition at HSPH.

The researchers, including senior author Frank Hu, professor of nutrition and epidemiology at HSPH, and colleagues, prospectively observed 37,698 men from the Health Professionals Follow-up Study for up to 22 years and 83,644 women in the Nurses’ Health Study for up to 28 years who were free of cardiovascular disease (CVD) and cancer at baseline. Diets were assessed through questionnaires every four years.

A combined 23,926 deaths were documented in the two studies, of which 5,910 were from CVD and 9,464 from cancer. Regular consumption of red meat, particularly processed red meat, was associated with increased mortality risk. One daily serving of unprocessed red meat (about the size of a deck of cards) was associated with a 13% increased risk of mortality, and one daily serving of processed red meat (one hot dog or two slices of bacon) was associated with a 20% increased risk.

Among specific causes, the corresponding increases in risk were 18% and 21% for cardiovascular mortality, and 10% and 16% for cancer mortality. These analyses took into account chronic disease risk factors such as age, body mass index, physical activity, family history of heart disease, or major cancers.

Red meat, especially processed meat, contains ingredients that have been linked to increased risk of chronic diseases, such as cardiovascular disease and cancer. These include heme iron, saturated fat, sodium, nitrites, and certain carcinogens that are formed during cooking.

Replacing one serving of total red meat with one serving of a healthy protein source was associated with a lower mortality risk: 7% for fish, 14% for poultry, 19% for nuts, 10% for legumes, 10% for low-fat dairy products, and 14% for whole grains. The researchers estimated that 9.3% of deaths in men and 7.6% in women could have been prevented at the end of the follow-up if all the participants had consumed less than 0.5 servings per day of red meat.

“This study provides clear evidence that regular consumption of red meat, especially processed meat, contributes substantially to premature death,” said Hu. “On the other hand, choosing more healthful sources of protein in place of red meat can confer significant health benefits by reducing chronic disease morbidity and mortality.”

Support for the study was provided by the National Heart, Lung, and Blood Institute and the National Cancer Institute.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

March, 2012|Oral Cancer News|

HPV a gender-neutral killer

Source: DailyPress.com

Socially conservative lawmakers will likely repeal Virginia’s requirement that schoolgirls get vaccinated against a sexually transmitted virus called HPV that can, and now will, kill many of them.

They’re repealing it in the name of sexual abstinence, family values and apple pie. In the name of keeping government out of private health-care decisions — and, yes, they say that with a straight face.

A body count doesn’t bother them.

Virtually all cervical cancer is caused by the human papillomavirus, which infects about 80 percent of sexually active adults by age 40. Most don’t even know they have it.

But, in some women, the virus mutates cells lining the cervix, turning them into cancerous lesions. About 12,000 women each year are diagnosed with cervical cancer, and 4,000 of them will die of it, according to the National Cancer Institute.

This vaccine would prevent nearly all that cancer. All that death.

Yet for moral reasons, not medical, the GOP-controlled House voted last month to eliminate the state’s 2007 requirement that girls receive the vaccine before enrolling in sixth grade. (The vaccine is most effective before the onset of sexual activity.)

The bill now goes to the GOP-controlled Senate, where it’s also expected to pass.

Lawmakers in Richmond weren’t swayed by appeals to conscience, to logic or to medicine. They didn’t care that the law already allows parents to decline the vaccine for their child for any reason whatsoever. They even rejected an amendment by a socially conservative colleague, Del. Chris Stolle, to at least get information about the vaccine to Virginia parents so they can make their own decision. Stolle is an obstetrician-gynecologist from Virginia Beach.

But conservative politicians and parents contend the vaccine will only encourage minors to have unprotected sex. As if the dim prospect of possibly developing cervical cancer in 20 or 30 years ever encouraged abstinence in teens.

The flip side of that reasoning, of course, is that if minors do have sex, they deserve whatever they get.

Vaccine proponents are gnashing their teeth. If only HPV weren’t identified as a “female problem,” they say, maybe lawmakers would take it more seriously. More compassionately. Maybe they’d give a damn.

Well, good news for everybody:

Researchers now predict that HPV will soon cause more head and neck cancers than cervical cancers.

A study published in the Journal of Clinical Oncology last October claims that rates of oropharyngeal cancer — a type of oral cancer — has jumped dramatically in the U.S. since 1984, “with HPV-related tumors accounting for a growing majority of new cases.”

“These increases may reflect increases in sexual behavior,” wrote the study’s lead author, Maura Gillison, “including increases in oral sex.”

Gillison is professor of medicine and Jeg Coughlin Chair of Cancer Research at The Ohio State University Comprehensive Cancer Center in Columbus.

In 1984, only 16 percent of oral cancer was HPV-related. By 2004, that number had rocketed to more than 72 percent. Based on these rates, researchers predict the incidence of oropharyngeal cancers will outpace cervical cancer by 2020.

The kicker? The HPV vaccine would also prevent virtually all HPV-positive oral cancers.

Do you think this revelation will sway social conservatives to stop the repeal?

Hell no. If anything, it will only convince holier-than-thous that the vaccine must be banished not only from Virginia public schools, but from the face of the God-fearing earth.

You see, such people can’t be reasoned with. They don’t care that a woman can stay chaste till marriage, only to be infected by a bridegroom who didn’t. They don’t care that a woman — or a child — can be raped. They don’t care that a woman can trust too much or make the wrong choices. They don’t care that men account for much of the increase in oral cancers.

And these people are in Richmond — running roughshod.

That’s not just a woman’s problem. That’s everybody’s problem.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

 

February, 2012|Oral Cancer News|

Adaptive radiotherapy may benefit patients with head and neck cancer

Source: News-Medical.net

Researchers led by a senior investigator at Hofstra-North Shore LIJ School of Medicine and The Feinstein Institute for Medical Research have released initial findings from a first-of-a-kind clinical trial in adaptive radiotherapy (ART) for head and neck cancer. The trial, sponsored by the National Cancer Institute, provides evidence that ART may benefit patients with less technical difficulty than previously believed. The findings of this trial were released online in advance of publication in the International Journal of Radiation Oncology Biology Physics.

Physicians commonly use radiotherapy to treat squamous cell carcinoma of the oropharynx (back of throat). Current standard-of-care treatment is called intensity-modulated radiotherapy, or IMRT. IMRT allows physicians to “sculpt” radiation to fit the anatomy of individual patients. Although appealing, this technique has a crucial Achilles’ heel – it is based entirely on a CT or MRI scan taken before actual treatment begins. Since a typical course of radiation treatment for oropharynx cancer lasts 6-7 weeks, standard IMRT cannot compensate for common changes that take place in a patient’s body during this time, such as weight loss, shrinkage of tumor, or gradual movement of normal tissues. Recent work suggests that the inability of standard IMRT to keep up with these changes may lead to unanticipated toxicity, or potentially worse, missing of tumor.

For this new trial, which was conducted at the University of Texas M.D. Anderson Cancer Center, investigators started patients on standard IMRT. They then took CT scans while patients were lying in the radiation treatment room each day so they could monitor changes in tumor and normal tissues during the entire course of treatment. Through computerized techniques, the investigators “adapted” (thus the name “adaptive radiotherapy“) treatment if they noticed significant tumor or body changes that could affect quality of treatment. Most strikingly, the group found that most patients required only one, or at most two adaptions of IMRT to maintain treatment quality.

“This is the first prospective clinical trial of its kind to gauge how “refitting” of IMRT to a patient’s body actually impacts care for a patient who has head and neck cancer,” noted David Schwartz, MD, vice-chair of radiation medicine at the North Shore-LIJ Health System, associate professor at the Hofstra North Shore-LIJ School of Medicine, and a senior investigator at The Feinstein Institute for Medical Research. “What most encouraged us was that ART appears effective with only 1 or 2 additional replans. This means that ART does not have to be overly burdensome or expensive to make a difference. This is something that is feasible, and could eventually make a real-world difference in many clinics.”

“ART keeps radiation treatment tightly fitted to a patient’s body, almost as if it were being shrink-wrapped,” Schwartz added. “It is as individualized as our current treatment can realistically be.”

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

February, 2012|Oral Cancer News|

Grape seed extract kills head and neck cancer cells, leaves healthy cells unharmed

Source: Colorado Cancer Blog

Nearly 12,000 people will die of head and neck cancer in the United States this year and worldwide cases will exceed half a million.

A study published this week in the journal Carcinogenesis shows that in both cell lines and mouse models, grape seed extract (GSE) kills head and neck squamous cell carcinoma cells, while leaving healthy cells unharmed.

“It’s a rather dramatic effect,” says Rajesh Agarwal, PhD, investigator at the University of Colorado Cancer Center and professor at the Skaggs School of Pharmaceutical Sciences.

It depends in large part, says Agarwal, on a healthy cell’s ability to wait out damage.

“Cancer cells are fast-growing cells,” Agarwal says. “Not only that, but they are necessarily fast growing. When conditions exist in which they can’t grow, they die.”

Grape seed extract creates these conditions that are unfavorable to growth. Specifically, the paper shows that grape seed extract both damages cancer cells’ DNA (via increased reactive oxygen species) and stops the pathways that allow repair (as seen by decreased levels of the DNA repair molecules Brca1 and Rad51 and DNA repair foci).

“Yet we saw absolutely no toxicity to the mice, themselves,” Agarwal says.

Grape seed extract kills head and neck squamous cell carcinoma cells while leaving healthy cells unharmed (image courtesy of Flickr user Anders Ljungberg)

Again, the grape seed extract killed the cancer cells but not the healthy cells.

“I think the whole point is that cancer cells have a lot of defective pathways and they are very vulnerable if you target those pathways. The same is not true of healthy cells,” Agarwal says.

The Agarwal Lab hopes to move in the direction of clinical trials of grape seed extract, potentially as an addition to second-line therapies that target head and neck squamous cell carcinoma that has failed a first treatment.

This work was supported by the R01 grants AT003623 from the National Center for Complementary and Alternative Medicine and CA91883 from the National Cancer Institute, NIH.

January, 2012|Oral Cancer News|

Prevalence of Oral HPV Infection Higher Among Men Than Women

CHICAGO — The overall prevalence of oral human papillomavirus (HPV) infection is approximately 7 percent among men and women ages 14 to 69 years in the United States, while the prevalence among men is higher than among women, according to a study appearing in JAMA. The study is being released early online to coincide with its presentation at the Multidisciplinary Head and Neck Cancer Symposium.

Oral HPV infection is the cause of a subset of oropharyngeal [relating to the mouth and pharynx] squamous cell carcinomas (OSCC).  Human papillomavirus positive OSCC are associated with sexual behavior in contrast to HPV-negative OSCC that are associated with chronic tobacco and alcohol use. At least 90 percent of HPV-positive OSCC are caused by high-risk (or oncogenic) HPV type 16 (HPV-16), and oral infection confers an approximate 50-fold increase in risk for HPV-positive OSCC. The incidence of OSCC has significantly increased over the last 3 decades in several countries, and HPV has been directly implicated as the underlying cause, according to background information in the article. Although oral HPV infection is the cause of a cancer that is increasing in incidence in the United States, little is known regarding the epidemiology of infection.

Maura L. Gillison, M.D., Ph.D., of the Ohio State University Comprehensive Cancer Center, Columbus, and colleagues examined the  prevalence of oral HPV infection in the United States. The researchers used data from a cross-sectional study as part of the National Health and Nutrition Examination Survey (NHANES) 2009-2010, a statistically representative sample of the U.S. population. Men and women ages 14 to 69 years examined at mobile examination centers were eligible.

Participants (n = 5,579) provided a 30-second oral rinse and gargle with mouthwash. For detection of HPV types, DNA purified from oral exfoliated cells was evaluated via testing methods. The researchers found that the overall prevalence of oral HPV infection was 6.9 percent, and the most prevalent HPV type detected was HPV-16 (1.0 percent). The prevalence of oral HPV infection had peaks in different age ranges, with a first peak in prevalence observed among those 30 to 34 years of age (7.3 percent) and a second, higher peak among those ages 60 to 64 years (11.4 percent). Men had a significantly higher prevalence than women for overall oral HPV infection (10.1 percent vs. 3.6 percent). Prevalence of HPV was higher among current smokers and heavy alcohol drinkers and among former and  current marijuana users.

The authors also found that oral HPV prevalence was associated with several measures of sexual behavior, including higher prevalence among individuals who reported ever having had sex vs. not (7.5 percent vs. 0.9 percent). Prevalence of HPV increased with lifetime or recent number of partners for any kind of sex, vaginal sex, or oral sex.

In analysis inclusive of individuals 14 to 69 years of age, factors independently associated with prevalent oral HPV included age, sex,  lifetime number of sexual partners, and current number of cigarettes smoked per day. The researchers write that their data provide evidence that oral HPV infection is predominantly sexually transmitted. ?Taken together, these data indicate that transmission by casual, nonsexual contact is likely to be unusual.

Our results have important research as well as public health implications. Natural history studies of cervical HPV infection were  essential for the development of public health interventions, such as HPV vaccination to prevent and HPV detection to screen for cervical cancer, they write. Natural history studies of oral HPV infection are therefore necessary to understand the effects of age, sex, and modifiable risk factors (e.g., smoking and sexual behavior) on the incidence and duration of oral HPV infection.

Vaccine efficacy against oral HPV infection is unknown, and therefore vaccination cannot currently be recommended for the primary  prevention of oropharyngeal cancer. Given an analysis of U.S. cancer registry data recently projected that the number of HPV-positive  oropharyngeal cancers diagnosed each year will surpass that of invasive cervical cancers by the year 2020, perhaps such vaccine  trials are warranted. Such trials could inform ongoing discussions regarding the benefits of HPV vaccination for males, given the higher  prevalence of oral HPV infection demonstrated here as well as higher incidence of HPV-positive OSCC among men, the authors conclude.

Editor’s Note: This study was supported by the Ohio State University Comprehensive Cancer Center, Merck, John and Nina Cassils, and the Intramural Research Program of the National Cancer Institute. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr. Gillison is the principal investigator of the unrestricted grant from Merck in support of this study and has been a consultant to Merck and GlaxoSmithKline. No other disclosures were reported. Please see the article for additional information, including other authors, author contributions and affiliations, etc.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

January, 2012|Oral Cancer News|

U.S. Government rolls out new teen anti-smoking program

Source:EmaxHealth.com

As 2012 draws nigh, many smokers will make yet another resolution to quit smoking. However, in a matter of days or weeks, many of them will be puffing away. Many of these smokers have damaged their health from the habit with ailments including chronic obstructive pulmonary disease (COPD), lung cancer, and throat cancer. One group of smokers is not yet afflicted with those ailments and would benefit the most from quitting: teen smokers. Unfortunately, however, research suggests most of those teens will keep smoking and some light smokers will become heavy smokers.

According to current estimates, 19% of U.S. teens are smokers by the 12th grade. To address this issue, the National Cancer Institute (NCI) is introducing a new smoking-cessation program focused on teens. At present, a Website has been developed (teen.smokefree.gov) and texting support is available. In January 2012, the NCI will add a smartphone application. The program joins others with the same aim: Helping teen smokers quit before they become chronic adult smokers. For example, on September 1, Secretary of Health and Human Services Kathleen Sebelius published an opinion in the Washington Post in which she pointed out the national problem of teen smoking.

A new study by the National Institutes of Health (NIH), released on December 14, reported that smoking had declined among U.S. teens. Countering that bit of good news was that one out of every 15 high school students smoked marijuana on a regular basis. Smoked marijuana and smoked tobacco are chemically very similar; thus, like cigarettes, the greatest health hazard of marijuana is due to smoking. The chief difference between the two plants is that marijuana contains THC and tobacco contains nicotine. Moreover, one of the most potent carcinogens in tobacco smoke, benzo(α)pyrene, is present in larger quantities in marijuana smoke.

The new federal teen smoking-cessation program focuses on:

  • Messages that emphasize teens are in charge. One slogan on the site about teens and their health decisions: “We’re NOT going to tell you what to do.”
  • Materials that focus on teen-specific triggers. Those include mood, social life, test anxiety and peer pressure.
  • Technologies teens use. Teens who want to quit can text QUIT to iQUIT (47848) to start getting helpful messages or go to the website to connect with counselors via instant messaging or phone. They also can join support networks on Facebook, Twitter and Tumblr.

Many teens are not receptive to messages describing future health problems because they have little interest in a disease that may not affect them for decades. However, teen smokers are receptive to messages about staining their teeth, smelling bad, wasting money, harming the environment, and even the fact that second-hand smoke can be harmful to their siblings and pets.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

December, 2011|Oral Cancer News|

Study Endorses HPV Testing for All Women Over 30

Source: Medscape.com

LONDON (Reuters) Dec 15 – New DNA tests looking for the virus responsible for most cases of cervical cancer make sense for all women aged 30 or over, since they can prevent more cases of cancer than Pap smears alone, Dutch researchers say.

Results of a five-year study involving 45,000 women provided the strongest evidence yet in favor of using human papillomavirus (HPV) testing, Dr. Chris Meijer and colleagues from the VU University Medical Centre in Amsterdam reported in The Lancet Oncology on December 15.

In recent years, tests for high-risk HPV strains have been developed by companies including Roche and Qiagen.

The new tests are known to work well in detecting HPV, but the Dutch study is the first to show they are better than Pap smears alone over two screening rounds set five years apart.

The researchers, who looked at women aged 29 to 56, said use of HPV tests led to earlier detection of pre-cancerous lesions, allowing for treatment that improved protection against cancer.

Dr. Hormuzd Katki and Dr. Nicolas Wentzensen from the U.S. National Cancer Institute said the results reinforced earlier findings, and provided “overwhelming evidence” of the benefits of including HPV testing in cervical screening programs.

The government-backed U.S. Preventive Services Task Force currently urges women who have been sexually active and have a cervix to get Pap smears at least every three years. However, the group recommends against routinely screening women over 65 if they had normal results on a recent Pap smear.

December, 2011|Oral Cancer News|