HUMAN-PAPILLOMAVIRUS AND RISK OF ORAL-CANCER

Although human papillomavirus (HPV), a sexually transmitted virus, is established as a necessary cause for more than 95% of cervical carcino mas, the association with oral squamous cell carcinoma is less well de lineated. The purpose of this study was to determine the frequency and types of HPV in squamous cells of a group of patients with newly diag nosed oral or pharyngeal cancer (n = 93) compared with an age- and gen der-frequency-matched control group of patients with no history of ora l cancer (n = 205), HPV was evaluated from a mouth rinse collection of cells in the oral cavity and tested by P-32-labeled RPV generic probe s and DNA sequencing for HPV types. HPV was identified in 15% of the o ral cancer cases but in fewer than 5% of the controls (P < .05), The r isk of cancer associated with HPV infection was independent of tobacco and alcohol use (adjusted odds ratio [OR] = 3.70; 95% confidence inte rval [CI]: 1.47-9.32; P < .05). HPV types included similar and other t ypes not identified previously in the genital tract, There was no stat istically significant increased risk of cancer among former tobacco us ers (former vs. never users: adjusted OR = 0.67, 95% CI: 0.31-1.44, P < .05), but the risk was significantly increased for current users (cu rrent vs. never: adjusted OR = 2.63; 95% CI: 1.22-5.71; P < .05), Like wise, former alcohol users were not at increased risk of disease (form er vs. never: adjusted OR = 1.78; 95% CI: 0.87-6.67), whereas current alcohol users were (current vs. never: adjusted OR = 2.57; 95% CI: 1.2 2-5.42; P < .05). HPV-related genital lesions (14.3% vs. 10.6%), oral genital sexual behavior (42.4% vs. 45.2%), and number (11 or more) of sexual partners (23% v. 17%) were not significantly different between cases and controls. These data suggest that in addition 60 tobacco and alcohol, HPV plays a role in the development of oral cancer.