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Promise and Progress - Tobacco and Oral Cancer-Causing Infection

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Tobacco and Oral Cancer-Causing Infection

Date: January 15, 2015

JAMA, Oct. 7, 2014

Tobacco use and exposure has been linked to oral-cancer causing infection with the human papillomavirus type 16 (HPV16). 

Earlier work by the Kimmel Cancer Center/Bloomberg School of Public Health research team linked HPV16 infection through oral sex with 80 percent of cancers of the mouth and throat.  Lead researchers Carole Fakhry, M.D., M.P.H., and Gypsyamber D’Souza, Ph.D., M.S., M.P.H., were seeking to reconcile the common practice of oral sex with the low rates of HPV-positive oral cancers.  “We knew there must be co-factors in the process that explain why some people develop persistent HPV16 infections and HPV-positive oropharyngeal cancers when most other people don’t,” says D’Souza, associate professor of epidemiology.  “It appears that tobacco exposure increases the likelihood of having oral HPV16 infection, and although we do not yet know why, we suspect that the virus may not be cleared from the body as easily in people who use tobacco.”

Previous studies have shown an association between oral HPV16 infection and cigarette use. The latest study expanded upon this work by considering all tobacco exposure, even secondhand smoke.  The researchers emphasize that tobacco use and exposure increase the risk—but do not directly cause—HPV16 infection.  Nonsmokers can become infected with HPV16. 

The study results suggest that even modest amounts of tobacco use are associated with higher oral HPV prevalence,” says Carole Fakhry, M.D., M.P.H., assistant professor of otolaryngology-head and neck surgery.  “It may provide an additional reason for smoking cessation.”

The research was funded by the National Institute of Dental and Craniofacial Research (P50 DE019032, R01 DE021395, R01 DE023175), the Milton J. Dance, Jr., Head and Neck Center at Greater Baltimore Medical Center, and Merck.

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