Human papillomavirus (HPV) causes the majority of oropharyngeal cancers in the United States, but we do not yet have any effective screening methods to detect these cancers. This knowledge gap is in part due to difficulties identifying oropharyngeal precursor lesions. However, several promising salivary and blood biomarkers have recently emerged that may be good markers of persistent oral HPV16 infection, the presumed pre-cursor to HPV-related oropharyngeal cancer. Given the increasing incidence of HPV-related oropharyngeal cancer, I propose to study the oral HPV continuum to answer the following 4 questions: 1) who is at high- risk for HPV-OPC and would benefit from screening, 2) What are the biologic and behavioral factors promoting oral HPV persistence and how can we reduce their effects, 3) how to optimally screen for persistent oral HPV16 infection and HPV-OPC, and 4) How to follow and treat people who screen positive for these biomarkers to prevent the development of HPV-related oropharyngeal cancer.
/ Relevance This study explores who is at high risk for persistent oral HPV16 infection and progression, how to best screen these individuals, and how to follow and treat screen-positive individuals to prevent HPV-OPC development. Understanding the biologic and behavioral risk factors for persistent oral HPV infection, and how to effectively screen those at highest risk of progression, will inform prevention and early detection of these cancers.
|Gipson, Brooke J; Robbins, Hilary A; Fakhry, Carole et al. (2018) Sensitivity and specificity of oral HPV detection for HPV-positive head and neck cancer. Oral Oncol 77:52-56|
|Windon, Melina J; D'Souza, Gypsyamber; Rettig, Eleni M et al. (2018) Increasing prevalence of human papillomavirus-positive oropharyngeal cancers among older adults. Cancer 124:2993-2999|
|Fakhry, Carole; Krapcho, Martin; Eisele, David W et al. (2018) Head and neck squamous cell cancers in the United States are rare and the risk now is higher among white individuals compared with black individuals. Cancer 124:2125-2133|
|D'Souza, G; McNeel, T S; Fakhry, C (2017) Understanding personal risk of oropharyngeal cancer: risk-groups for oncogenic oral HPV infection and oropharyngeal cancer. Ann Oncol 28:3065-3069|