Researchers at Albert Einstein College of Medicine have found that when human papillomavirus (HPV)-16 is detected in peoples' mouths, they are 22 times more likely than those without HPV-16 to develop a type of head and neck cancer. The study was published online today in JAMA Oncology and was led by Ilir Agalliu, M.D., Sc.D., and Robert D. Burk, M.D.
HPV-16 is a well-known cause of head and neck cancers. A rising proportion of these cancers are oropharyngeal cancers (cancers of the middle part of the throat including the soft palate, the base of the tongue and the tonsils). This study is the first to demonstrate conclusively that HPV-16's presence in the oral cavity precedes the development of oropharyngeal cancers. (HPV-16 is also responsible for the majority of cervical cancers.) Other studies indicate that detection of HPV in the oral cavity is related to sexual behavior.
The Einstein study involved nearly 97,000 people taking part in two large, national prospective studies. At the start of the studies, participants provided mouthwash samples and were cancer-free. A total of 132 cases of head and neck cancer were identified during an average of nearly four years of follow-up. The study also included a comparison group of 396 healthy subjects (controls), i.e., three controls for each case. Mouthwashes samples for head-and-neck cancer cases and for the controls were analyzed for the presence of several types of oral HPVs.
People with HPV-16 in their mouthwash samples were 22 times more likely to develop oropharyngeal cancer than were study participants with no detectable HPV-16 in their samples, the researchers found. In addition, the researchers found for the first time that the presence of other types of oral HPVs–beta- and gamma-HPVs, which are usually detected in the skin–was also associated with the development of head and neck cancers, indicating a broader role for HPVs in causing these cancers than has been recognized to date. This study shows that using easily collected oral mouthwash samples may help in predicting people's risk for developing head and neck cancers.
Dr. Agalliu is assistant professor of epidemiology and population health and Dr. Burk is professor of pediatrics, of microbiology & immunology, of obstetrics & gynecology and women's health and of epidemiology & population health at Einstein and attending physician, pediatrics at Montefiore Health System. Drs. Agalliu and Burk are also members of the NCI-designated Albert Einstein Cancer Center's Cancer Epidemiology program.
The study is titled "Associations of Oral Alpha, Beta, and Gamma Human Papillomavirus Types With Risk of Incident Head and Neck Cancer." In addition to Drs. Agalliu and Burk, other Einstein authors are Tao Wang, Ph.D., and Zigui Chen, Ph.D. Additional authors are Susan Gapstur, Ph.D., Rebecca L. Anderson, M.P.H., and Lauren Teras, Ph.D., at the American Cancer Society, Atlanta, GA; Aimee R. Kreimer, Ph.D. and Neal D. Freedman, Ph.D. at the National Cancer Institute, National Institutes of Health, Bethesda, MD; and Richard B. Hayes, Ph.D., at New York University, New York.
This study was supported by public funds through a grant to Drs. Agalliu and Burk from the National Institutes of Health (R21-CA152785-2 and P30-CA013330). The authors report no conflicts of interest.
About Albert Einstein College of Medicine
Albert Einstein College of Medicine is one of the nation's premier centers for research, medical education and clinical investigation. During the 2015-2016 academic year, Einstein is home to 731 M.D. students, 193 Ph.D. students, 106 students in the combined M.D./Ph.D. program, and 278 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2015, Einstein received $148 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore Medical Center, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Through its extensive affiliation network involving Montefiore, Jacobi Medical Center–Einstein's founding hospital, and three other hospital systems in the Bronx, Brooklyn and on Long Island, Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States. For more information, please visit www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.