Background Incidence of human papillomavirus (HPV)-related oropharyngeal cancer is increasing. There is interest in identifying healthy individuals most at risk for development of oropharyngeal cancer to inform screening strategies. Patients and methods All data are from 2009 to 2014, including 13 089 people ages 20-69 in the National Health and Nutrition Examination Survey (NHANES), oropharyngeal cancer cases from the Surveillance, Epidemiology, and End Results (SEER 18) registries (representing ∼28% of the US population), and oropharyngeal cancer mortality from National Center for Health Statistics (NCHS). Primary study outcomes are (i) prevalence of oncogenic HPV DNA in an oral rinse and gargle sample, and (ii) incident oropharyngeal squamous cell cancer. Results Oncogenic oral HPV DNA is detected in 3.5% of all adults age 20-69 years; however, the lifetime risk of oropharyngeal cancer is low (37 per 10 000). Among men 50-59 years old, 8.1% have an oncogenic oral HPV infection, 2.1% have an oral HPV16 infection, yet only 0.7% will 'ever' develop oropharyngeal cancer in their lifetime. Oncogenic oral HPV prevalence was higher in men than women, and increased with number of lifetime oral sexual partners and tobacco use. Men who currently smoked and had ≥5 lifetime oral sexual partners had 'elevated risk' (prevalence = 14.9%). Men with only one of these risk factors (i.e. either smoked and had 2-4 partners or did not smoke and had ≥5 partners) had 'medium risk' (7.3%). Regardless of what other risk factors participants had, oncogenic oral HPV prevalence was 'low' among those with only ≤1 lifetime oral sexual partner (women = 0.7% and men = 1.7%). Conclusions Screening based upon oncogenic oral HPV detection would be challenging. Most groups have low oncogenic oral HPV prevalence. In addition to the large numbers of individuals who would need to be screened to identify prevalent oncogenic oral HPV, the lifetime risk of developing oropharyngeal caner among those with infection remains low.

中文翻译：

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了解口咽癌的个人风险：致癌口腔 HPV 感染和口咽癌的风险组。

背景 人乳头瘤病毒 (HPV) 相关口咽癌的发病率正在增加。人们有兴趣识别最有可能患口咽癌的健康个体，以告知筛查策略。患者和方法 所有数据均来自 2009 年至 2014 年，包括全国健康和营养检查调查 (NHANES) 中的 13 089 名 20-69 岁的人，来自监测、流行病学和最终结果 (SEER 18) 登记处的口咽癌病例（代表约 28% 的美国人口），以及来自国家卫生统计中心 (NCHS) 的口咽癌死亡率。主要研究结果是 (i) 口腔冲洗液和漱口液样本中致癌 HPV DNA 的流行率，以及 (ii) 偶发口咽鳞状细胞癌。结果 3.5% 的 20-69 岁成年人检测到致癌口腔 HPV DNA；然而，口咽癌的终生风险很低（每 10 000 人中有 37 人）。在 50-59 岁的男性中，8.1% 的人患有致癌性口腔 HPV 感染，2.1% 的人患有口腔 HPV16 感染，但只有 0.7% 的人会在其一生中“永远”患上口咽癌。男性的致癌性口腔 HPV 患病率高于女性，并且随着终生口腔性伴侣的数量和烟草使用的增加而增加。目前吸烟并拥有 ≥5 个终生口交性伴侣的男性“风险升高”（患病率 = 14.9%）。只有这些风险因素之一的男性（即吸烟并有 2-4 个伴侣或不吸烟但有 ≥5 个伴侣）具有“中等风险”（7.3%）。无论参与者有什么其他风险因素，在只有 ≤1 个终生口交性伴侣（女性 = 0.7%，男性 = 1.7%）的人群中，致癌口腔 HPV 的流行率“低”。结论 基于致癌口腔 HPV 检测的筛查将具有挑战性。大多数群体的致癌性口腔 HPV 患病率较低。除了需要对大量个体进行筛查以确定流行的致癌口腔 HPV 之外，感染者患口咽癌的终生风险仍然很低。