Study: HPV-Linked Throat Cancer Remains Rare

Only 1% of women aged 20 to 68 years had an oral HPV infection.

The human papillomavirus (HPV) is known to cause several types of cancer, including cervical and oropharyngeal cancers. With the incidence of HPV-associated cancers increasing over the past few decades, it is recommended that young children are vaccinated against the virus.

Despite the potential for cancer related to HPV, the authors of a recent study published by the Annals of Oncology found that the risk of associated throat cancers is low.

“Despite recent increases in its incidence, HPV-associated oropharyngeal cancer remains a rare cancer in the US,” said co-author Carole Fakhry, MD, MPH.

Recently, the authors found that there has been interest in testing for oral HPV infections to screen for those at high risk of oropharyngeal cancer; however, the study results suggest that the testing may be unnecessary.

“Currently available tests for the presence of oral HPV infections are not very predictive of oropharyngeal cancer risk—most people who have an oral HPV infection will eventually clear it on their own,” said study co-author Gypsyamber D’Souza, PhD.

Approximately 70% of oropharyngeal cancers are caused by the virus. HPV-associated throat cancers account for 12,000 cases of the cancer that affects the back of the throat, base of the tongue, and tonsils, according to the authors.

Included in the new study were behavioral and medical data from 13,089 adults included in the National Health and Nutrition Examination Survey. Patients underwent oral HPV tests.

The authors found that oral HPV infections were rare in each cohort. Specifically, only 1% of women aged 20 to 68 years had the infection, while 6% of age-matched males had the infection. Men aged 50 to 59 years were the most likely to have the infection at 8.1%, according to the study.

The investigators discovered several factors that may increase the risk of oral HPV, including sexual history and smoking status.

The authors caution that HPV infections vary in effect, since some types of the virus carry a higher risk of cancer. HPV type 16 is estimated to cause more than 90% of oropharyngeal cancers. The rate of HPV 16 prevalence in the study ranged from 0.1% in women and 2.4% in men aged 60 to 69 years, according to the authors.

“For most people, these data should be very reassuring, as they show that their risk of oropharyngeal cancer is very low,” Dr D’Souza said.

These findings suggest that mass screening for oral HPV is not sensible since current tests can lead to false positive results, which can cause anxiety without accurately predicting cancer risk, according to the study.

The authors said they are working to develop more accurate HPV tests that may better predict the risk of oropharyngeal cancer.

“We have ongoing studies of strategies for using biomarkers to determine and stratify people’s oropharyngeal cancer risk,” Dr Fakhry said.