MedicalResearch.com Interview with:
Ilir Agalliu, M.D., Sc.D.
Assistant Professor, Department of Epidemiology & Population Health and Department of Urology
Albert Einstein College of Medicine
Jack and Pearl Resnick Campus
Medical Research: What is the background for this study?
Dr. Burk: We performed this study since we had previously detected an unusually high prevalence of HPV types found on the skin and skin cancers in the oral cavity in addition to HPV16 and other high-risk (HR) types (as defined by their association with cervix cancer) (see Journal of Infectious Diseases 204:787, 2011). We wished to determine if these types were associated with risk of head and neck cancers (HNSCCs). In addition, we wished to determine if HPV detection preceded the diagnosis of HNSCCs and might serve as a biomarker. Currently there are no good screening tests for HNSCC.
Dr. Agalliu: To-date, there have been no prospective studies examining the temporal relationship between oral HPV detection and risk of head and neck squamous cell carcinoma (HNSCC). In this manuscript we examined prospectively associations between detection of a wide spectrum of oral HPVs (alpha, beta and gamma) with incident HNSCC in a nested case-control study among ~100,000 participants who provided mouthwash samples in the American Cancer Society-CPS II cohort and the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.
Dr. Agalliu: Oral HPV16 detection, which preceded cancer development on average for 4 years, was associated with a 22-fold increased risk for incident oropharyngeal cancer.
Detection of other oral HPVs (beta1 HPV5, and gamma11 and 12 species) were associated with a 3.3 to 5.5-fold higher risk of head and neck squamous cell carcinoma after adjustment for smoking, alcohol and HPV16. Associations of beta and gamma HPVs, which have been identified in the skin, with risk of HNSCC suggest a broader role for HPVs in HNSCC etiology.
Medical Research: What should clinicians and patients take away from your report?
Dr. Burk: This study is important because it provides the first evidence that detection of HPV16 preceded the diagnosis of oropharyngeal cancer, suggesting the possibility of early detection of such HNSCC lesions. There are currently no good screening tests for HNSCC.
Dr. Agalliu: Associations of several oral HPVs, some of which were identified in the skin, with risk of head and neck squamous cell carcinoma suggest a broader role for HPVs in HNSCC etiology. This could have public health implications in the future; especially for development of vaccines that could target also beta and gamma HPVs.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Agalliu: Larger studies of oral HPVs are needed to better understand the association of various HPVs with subsets of HNSCC, as well as to explore potential interactions of HPVs with other risk factors for HNSCC, particularly cigarette smoking and alcohol consumption. In addition, prospective studies with multiple oral wash collections are needed to understand whether new or persistent infection with oral HPVs is associated with HNSCC.
MedicalResearch: Is there anything else you would like to add?
Dr. Burk: This study was supported by public funds through a grant to Drs. Agalliu and Burk (Co-Principal Investigators) from the National Cancer Institute of the NIH.
Ilir Agalliu, M.D., Sc.D. (2016). HPV Strains Raise Risk of Head and Neck Squamous Cell Cancer