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National Cervical Cancer Coalition


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 Post subject: hpv and oral cancer
PostPosted: Tue Feb 15, 2011 10:59 pm 

Joined: Fri Jan 21, 2011 11:42 am
Posts: 11
Location: United States
I know that a vast majority of sexually active people will be exposed to hpv but I am having a hard time finding out of the 90+% of people exposed to HPV; what % are exposed to hpv 16.

As a male this is something I am having a hard time assessing my true risk. My wife had a abnormal pap and positive for hpv about 2 years ago (didn’t do subtype test) and since then she has had 4 normal paps and a negative hpv 16/18 test (her body cleared it, as it seems to in a vast majority of cases), so I don’t know if she ever had hpv 16 or if someone I was with before might have had it and I was exposed to it. I know a lot of this is hearsay but I am concerned and really need some help on assessing my risk.

Does hpv 16 in the oral cavity still get cleared by body in over 90% of the case as I seems to in other areas such as the cervix in women?

Is this something I should be concerned about? Lately the moment I feel anything in my mouth and throat I think I might have oral cancer (I know that is a little buts) but my head is stuck on this topic, any insight on this would be helpful.


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 Post subject: Re: hpv and oral cancer
PostPosted: Tue Feb 15, 2011 11:10 pm 

Joined: Fri Jan 21, 2011 11:42 am
Posts: 11
Location: United States
just found this link with the stats on hpv 16 from the cdc;

can anyone confirm or expand on these.

http://www.stanford.edu/group/virus/pap ... /HPV16.htm

Epidemiology


HPV is one of the most common STDs among sexually active young people. The CDC estimates that 20 million people in the US are infected with HPV 16 and that every year, there are about 5.5 million new infections.

A study by the CDC on prevalence of HPV 16 in the US showed that the prevalence of HPV-16 was at least two-fold higher in women compared to men. Women of all races had an HPV-16 prevalence of 17.9 percent, compared to 8 percent for men. African-American women age 20 to 29 had the highest prevalence of HPV-16 at 36 percent. African Americans overall had 19.1 percent prevalence, compared to 12.5 percent in whites. The prevalence of HPV-16 was higher in study participants who had a larger number of lifetime sex partners. 7 percent of people with one lifetime sex partner had the infection compared to 20.1 percent of people with 50 or more lifetime sex partners. Overall, thirteen percent of the study population carried HPV-16 antibodies. However, the figure does not represent all people in the study with the infection because not all people who have been infected develop detectable antibodies.


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 Post subject: Re: hpv and oral cancer
PostPosted: Wed Feb 16, 2011 10:01 am 
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Joined: Wed Oct 04, 2006 4:08 pm
Posts: 2122
Location: North Carolina
Hi posterboy,

Interesting material you posted, for sure. I don't know of a figure that speaks as precisely to clearance rates of oropharyngeal HPV as we do with anogenital infection, but I am aware of a study from Finland a few years ago that found oral cavity HPV mimics its genital counterpart in many respects.

Perhaps the thing to focus on is that head and neck cancers (of which the HPV-related oropharyngeal tumors are a subset) are not a common disease, and the ones that are in fact linked to HPV are probably half or fewer of all types. While oral HPV infections aren't exactly rare, cancers related to this virus are. Of course if you have any symptoms about which you're worried then have them evaluated, but this is probably not something to lose much sleep over.

Don't get too hung up, either, on the prevalence of HPV-16 antibodies. Another study that looked not at antibodies, but at actual, detectable infections (assessed by DNA testing) in women found only 1.5% were positive for HPV-16. Of course, an exponentially higher number would almost certainly have been positive for HPV-16 antibodies, had they been tested for them.

I hope this helps.

Best,
Fredo

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 Post subject: Re: hpv and oral cancer
PostPosted: Wed Feb 16, 2011 9:49 pm 

Joined: Fri Jan 21, 2011 11:42 am
Posts: 11
Location: United States
hey fredo,

thanks for the insight. your point is a good one about the studies looking for antibodies instead of active infections.

i think the fact that less than 2% of the women in that large study showed acive hpv 16 inceftion when i think it is safe to estimate a high percentage of people would test postive for antibodies is soild evidence how often the virus never causes issues even 16 for a vast majority of people.

what i am curious about is that since hpv and in this case hpv 16 is common ; how can we know for sure that hpv 16 is causing about 18,000 cases of oral cancer a year istead of other genteic factors or life style factors (smoking, drinking, stress.etc ); is the fact the hpv 16 is the only common link people are assuming that is what is causing it? any insight for your research on that perspective?

of the about 30,000 cases of oral cancer onle i would be curious what % never had any other risk factors such as history of cancer, smoking, drinking, etc


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 Post subject: Re: hpv and oral cancer
PostPosted: Mon Mar 21, 2011 1:08 pm 

Joined: Mon Mar 21, 2011 12:37 pm
Posts: 1
Location: USA
Hi there,

I came across your post and think I might be able to help. There have been various studies that show differing incidence rates of oncogenic HPV. Some studies done in JAMA showed that 1.5% of 14-54 year old women have an active HPV 16 infection. The test used was a cervical swab and a PCR test to type the genome. However, in other studies done in Europe, an ELISA based test found that over 40% of the women tested had positive reactions to HPV-16 viral capsids. This implies that the women have antibodies to the virus and were most likely infected at some point. Previously, Maura Gillison used to say that a person with HPV 16 antibodies were at the highest risk of developing these orapharynx cancers. However, I believe that since research has shown HPV 16 antibodies to be prevalent, Gillison has changed her tune. She now supports a different risk profile for potential HPV related oral cancers.

The Oral Cancer Foundation has partnered with Gillison and other researchers to discover the HPV connection to oral cancer. It has since been determined that HPV 16 is the primary cause of orapharynx cancers, and the primary sites are almost always base of tongue and tonsils. The determination of this etiology is pretty scientific, and I won't get into it here. However, let's just say they can determine the origins of the tumor by looking at the DNA of the sample to figure out if HPV 16 is in there. So far, there are three groups of oral cancers that the Oral Cancer Foundation has been seeing.

HPV+ oral cancers that occur primarily in the base of tongue and tonsils.
HPV- cancers that are related to smoking and drinking that occur anywhere in the orapharynx.
HPV- cancers that have no understood etiology and also occur anywhere in the orapharynx.

The later two are usually more aggressive and have higher recurrence rates. The good news about HPV+ orapharynx cancers is that they have much better long term survival rates. About twice as good as HPV- ones.

Now, if you think about the odds ratio, it seems this cancer is quite rare. About 18,000 oral cancers are caused by this virus. Suppose 1.5% of the population over 14 has an active HPV 16 infection. Let's just say that's roughly 249 million people * .015. So, the odds ratio is 18,000 / 3735000 * 100% = 0.482% So, there is less than half percent odds that someone with an active HPV 16 infection will later develop an orapharynx related cancer.

Anyways, with all this said, you should understand the symptoms of this cancer for future sakes. Look at Michael Douglas's story for symptoms.


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