• 3/16/2004
  • New York
  • Rueters

Infection of oral epithelial cells with oncogenic types of human papillomavirus (HPV) is an independent risk factor for the development of head and neck cancer, investigators report in the March 17th issue of The Journal of the National Cancer Institute.

In a case-control study, Dr. Elaine M. Smith of the University of Iowa and colleagues detected oncogenic HPV types in oral exfoliated cells from 22.9% of 201 patients with head and neck cancer and 10.8% of 333 cancer-free control subjects.

HPV 16 was the most frequently detected type, present in 19% of cases and 10% of controls. In analyses adjusting for age, tobacco use, and alcohol intake, the risk of head and neck cancer was statistically significantly greater in subjects infected with high-risk HPV types, with an adjusted odds ratio of 2.6, but not in those infected with non-oncogenic HPV types (adjusted OR = 0.8)compared with HPV-negative individuals.

There was also a significant synergistic effect between detection of high-risk HPV types and heavy alcohol use (OR=18.8) and an additive effect between detection of high-risk HPV and tobacco use (OR = 5.5). “Any biologic interaction effect with HPV is associated primarily with alcohol consumption and not with tobacco use,” the researchers note. The team also found a significant association between detection of high-risk HPV in oral cells and detection of high-risk HPV in tumor tissue.

Head and neck cancers cause “clinically significant morbidity and disfiguration,” Dr. Smith and colleagues remind readers, making “early detection of disease and biomarkers to identify individuals at high risk of great importance.” With further study, “HPV testing of an oral rinse may be predictive of an HPV-related head and neck cancer,” they conclude.