Substantial molecular evidence suggests a role for human papillomavirus.
In the pathogenesis of oropharyngeal squamous-cell carcinoma, but epidemiologic data have been inconsistent.
Dr Gillison and colleagues from Baltimore performed a hospital-based, case-control study of 100 patients with newly diagnosed oropharyngeal cancer.
The investigative team compared these patients to 200 control patients without cancer.
The research team evaluated associations between human papillomavirus infection and oropharyngeal cancer.
|64% with cancer were seropositive for the human papillomavirus-16|
|The New England Journal of Medicine|
Multivariate logistic-regression models were used for case-control comparisons.
The investigators found a lifetime number of vaginal-sex partners of 26 or more was associated with oropharyngeal cancer.
The team noted that a lifetime number of 6 or more oral-sex partners was also associated with oropharyngeal cancer.
The degree of association increased with the number of vaginal-sex and oral-sex partners.
The investigators found that oropharyngeal cancer was significantly associated with oral human papillomavirus type 16 infection.
The team observed that oropharyngeal cancer was associated with oral infection with any of 37 types of human papillomavirus.
In addition, seropositivity for the human papillomavirus -16 L1 capsid protein was associated with oropharyngeal cancer.
Human papillomavirus -16 DNA was detected in 72% of paraffin-embedded tumor specimens.
The team observed that 64% of patients with cancer were seropositive for the human papillomavirus -16 oncoprotein E6, E7, or both.
Human papillomavirus -16 L1 seropositivity was associated with oropharyngeal cancer among subjects with a history of heavy tobacco and alcohol use.
The team noted that among those without such a history, human papillomavirus -16 L1 seropositivity was also associated with oropharyngeal cancer .
The team noted that the association was similarly increased among subjects with oral human papillomavirus-16 infection, regardless of their tobacco and alcohol use.
By contrast, tobacco and alcohol use increased the association with oropharyngeal cancer primarily among subjects without exposure to human papillomavirus -16.
Dr Gillison's team commented," Oral human papillomavirus infection is strongly associated with oropharyngeal cancer among subjects with or without the established risk factors of tobacco and alcohol use."