Purpose The incidence of human papilloma virus (HPV)-positive oropharyngeal cancers has risen rapidly in recent decades among men in the United States. We investigated the US population-level effect of prophylactic HPV vaccination on the burden of oral HPV infection, the principal cause of HPV-positive oropharyngeal cancers. Methods We conducted a cross-sectional study of men and women 18 to 33 years of age (N = 2,627) within the National Health and Nutrition Examination Survey 2011 to 2014, a representative sample of the US population. Oral HPV infection with vaccine types 16, 18, 6, or 11 was compared by HPV vaccination status, as measured by self-reported receipt of at least one dose of the HPV vaccine. Analyses accounted for the complex sampling design and were adjusted for age, sex, and race. Statistical significance was assessed using a quasi-score test. Results Between 2011 and 2014, 18.3% of the US population 18 to 33 years of age reported receipt of at least one dose of the HPV vaccine before the age of 26 years (29.2% in women and 6.9% in men; P < .001). The prevalence of oral HPV16/18/6/11 infections was significantly reduced in vaccinated versus unvaccinated individuals (0.11% v 1.61%; Padj = .008), corresponding to an estimated 88.2% (95% CI, 5.7% to 98.5%) reduction in prevalence after model adjustment for age, sex, and race. Notably, the prevalence of oral HPV16/18/6/11 infections was significantly reduced in vaccinated versus unvaccinated men (0.0% v 2.13%; Padj = .007). Accounting for vaccine uptake, the population-level effect of HPV vaccination on the burden of oral HPV16/18/6/11 infections was 17.0% overall, 25.0% in women, and 6.9% in men. Conclusion HPV vaccination was associated with reduction in vaccine-type oral HPV prevalence among young US adults. However, because of low vaccine uptake, the population-level effect was modest overall and particularly low in men.

中文翻译：

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预防性人乳头瘤病毒 (HPV) 疫苗接种对美国年轻人口腔 HPV 感染的影响

目的 近几十年来，美国男性中人乳头瘤病毒 (HPV) 阳性口咽癌的发病率迅速上升。我们调查了美国人群水平的预防性 HPV 疫苗接种对口腔 HPV 感染负担的影响，口腔 HPV 感染是 HPV 阳性口咽癌的主要原因。方法 我们对 2011 年至 2014 年全国健康和营养检查调查（美国人口的代表性样本）中 18 至 33 岁（N = 2,627）的男性和女性进行了横断面研究。16、18、6 或 11 型疫苗的口服 HPV 感染通过 HPV 疫苗接种状态进行比较，通过自我报告的至少一剂 HPV 疫苗接种情况来衡量。分析考虑了复杂的抽样设计，并根据年龄、性别和种族进行了调整。使用准分数检验评估统计显着性。结果 2011 年至 2014 年间，18.3% 的 18 至 33 岁美国人口报告在 26 岁之前至少接种过一剂 HPV 疫苗（女性为 29.2%，男性为 6.9%；P < .001 ）。接种疫苗的个体与未接种疫苗的个体相比，口腔 HPV16/18/6/11 感染的患病率显着降低（0.11% 对 1.61%；Padj = .008），对应于估计的 88.2%（95% CI，5.7% 到 98.5%）对年龄、性别和种族进行模型调整后流行率降低。值得注意的是，接种疫苗的男性与未接种疫苗的男性相比，口腔 HPV16/18/6/11 感染率显着降低（0.0% 对 2.13%；Padj = .007）。考虑到疫苗接种，HPV 疫苗接种对口腔 HPV16/18/6/11 感染负担的总体影响为 17.0%，25。女性为 0%，男性为 6.9%。结论 HPV 疫苗接种与美国年轻人中疫苗型口腔 HPV 流行率的降低有关。然而，由于疫苗接种率低，人群水平的影响总体上不大，尤其是男性。