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HPV oropharynx ca patients put partners at risk.

CHICAGO -- A high degree of concordance of oral human papilloma virus infection between HPV-positive patients with oropharynx cancer and their sexual partners suggests that partners are at high risk for HPV-related disease, according to a study from the University of Texas M.D. Anderson Cancer Center in Houston.

Investigators reported in a poster presentation that HPV was transmitted between HPV+ patients with oropharynx cancer and their sexual partners at a rate approaching 70%. Almost 60% of these cases involved HPV 16, a causative agent in head and neck squamous cell carcinoma, specifically tonsil cancer, as well as in most cervical malignant and premalignant conditions.

"There was a high rate of human papilloma virus transmission between oropharynx cancer (OPC) patients with HPV+ mouth swabs and their spouses or partners," said first author Dr. Vassiliki Papadimitrakopoulou, a professor in the department of thoracic/head and neck medical oncology at M.D. Anderson.

Human papilloma virus transmission between sexual partners is well documented in cervical cancer, but not in head and neck squamous cell carcinoma. Information on transmission could help define a population that would benefit from heightened cancer screening and vaccination. "HPV-related OPC occurs in a younger group of patients than does the tobacco-related squamous cell cancer of the head and neck," noted Dr. Anne Tsao, the study's principal investigator from the same department at M.D. Anderson.

The authors used mouth swabs to gather DNA from 454 individuals, comprising 227 pairs of oropharynx cancer patients and their partners. Samples from 200 patient-partner pairs yielded adequate DNA for analysis, and this was the minimum required to meet the study's planned accrual.

In situ hybridization and/or pl6 immunohistochemistry detected HPV in 84 (86%) of 98 patients, for whom complete information on HPV status in tumor tissue was available at the time of the presentation. Not all of these cases resulted in positive mouth swabs, however.

Of the 200 patient-partner pairs, only 39 (20%) had one or both members with a mouth swab testing positive for HPV In 28 of these 39 pairs (72%), the mouth swab was positive in patients, and in 19 of these 28 (68%) the partners also had positive mouth swabs.

The investigators reported 100% concordance for at least one human papilloma virus genotype in these 19 pairs, confirming that the virus had been exchanged between the partners; 58% of transmission cases involved HPV-16. In 11 of the 39 pairs, the patient with oropharynx cancer tested negative for HPV, whereas the partner tested positive.

Regardless of HPV status as determined by mouth swabs, 30% of female partners but none of the men reported a history of HPV-related disease.

The investigators observed that this generates a hypothesis that HPV affects the cervix at an earlier age than it does the oropharynx. The data "encourage" screening of female partners and HPV+ female patients for cervical abnormalities, they advised.


Major Finding: Mouth swabs from patients with oropharynx cancer and their sexual partners showed a 68% HPV transmission rate in pairs where the patient was positive for oral HPV infection.

Data Source: 39 HPV+ patient-partner pairs in a prospective cohort study of 200 patients with oropharynx cancer and their sexual partners.

Disclosures: The investigators and the discussant disclosed no relevant relationships. The National Cancer Institute funded the study.


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Author:Hyer, Richard
Publication:Internal Medicine News
Geographic Code:1USA
Date:Sep 15, 2010
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