NHANES 2009-2012 Findings: Association of Sexual Behaviors with Higher Prevalence of Oral Oncogenic Human Papillomavirus Infections in US Men
NHANES 2009-2012 Findings: Association of Sexual Behaviors with Higher Prevalence of Oral Oncogenic Human Papillomavirus Infections in US Men
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DOI：
10.1158/0008-5472.can-14-2843
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发表时间：
2015-06-15
期刊：
影响因子：
11.2
通讯作者：
Gillison, Maura L.
中科院分区：
文献类型：
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作者：
Chaturvedi, Anil K.;Graubard, Barry I.;Gillison, Maura L.
在美国，人乳头瘤病毒 (HPV) 阳性口咽癌的发病率在美国男性中比女性中更高且增长更快，原因不明。我们比较了 2009-2012 年美国国家健康和营养检查调查 (NHANES) 中 14 至 69 岁男性和女性 (N = 9,480) 口腔致癌 HPV 感染的流行病学。通过 PCR 检测口腔 DNA 中是否存在 HPV。分析按性别分层并使用 NHANES 样本权重。男性口腔致癌性 HPV 患病率高于女性（6.6% 比 1.5%，P < 0.001），2009-2012 年任何时间点，男性感染率分别为 707 万和 154 万女性。患病率随着年龄、当前吸烟情况和两性终生性伴侣数量的增加而显着增加（调整后的 P 趋势 < 0.02）。然而，男性比女性拥有更多伴侣（平均值 = 18 vs. 7，P < 0.001）。尽管对于有 0 到 1 个终生伴侣的男性和女性来说，致癌性 HPV 患病率相似，但随着终生伴侣数量的增加，男女患病率差异显着增加（无伴侣、1 个、2-5 个、6-10 个、11-20 个和 20 个以上伴侣的调整后患病率差异分别为 1.0%、0.5%、3.0%、5.7%、4.6% 和 9.3%）。重要的是，男性中同性伴侣患病率的增长明显强于女性（调整后的协同指数 = 3.3；95% 置信区间，1.1-9.7），并且这种增长在男性有 25 个终身伴侣时达到稳定水平，而女性中有 10 个伴侣时则达到稳定水平。我们的数据表明，男性口腔致癌性 HPV 感染和 HPV 阳性口咽癌的负担高于女性，部分原因是男性终生性伴侣数量较多，且与性行为的关联性更强。 (C) 2015 年 AACR。
The incidence of human papillomavirus (HPV)-positive oropharyngeal cancers is higher and increasing more rapidly among men than women in the United States for unknown reasons. We compared the epidemiology of oral oncogenic HPV infection between men and women ages 14 to 69 years (N = 9,480) within the U.S. National Health and Nutritional Examination Surveys (NHANES) 2009-2012. HPV presence was detected in oral DNA by PCR. Analyses were stratified by gender and used NHANES sample weights. Oral oncogenic HPV prevalence was higher among men than women (6.6% vs. 1.5%, P < 0.001), corresponding to 7.07 million men versus 1.54 million women with prevalent infection at any point in time during 2009-2012. Prevalence increased significantly with age, current smoking, and lifetime number of sexual partners for both genders (adjusted P-trend < 0.02). However, men had more partners than women (mean = 18 vs. 7, P < 0.001). Although oncogenic HPV prevalence was similar for men and women with 0 to 1 lifetime partners, the male-female difference in prevalence significantly increased with number of lifetime partners (adjusted prevalence differences for none, 1, 2-5, 6-10, 11-20, and 20+ partners = 1.0%, 0.5%, 3.0%, 5.7%, 4.6%, and 9.3%, respectively). Importantly, the per-sexual partner increase in prevalence was significantly stronger among men than among women (adjusted synergy index = 3.3; 95% confidence interval, 1.1-9.7), and this increase plateaued at 25 lifetime partners among men versus10 partners among women. Our data suggest that the higher burden of oral oncogenic HPV infections and HPV-positive oropharyngeal cancers among men than women arises in part from higher number of lifetime sexual partners and stronger associations with sexual behaviors among men. (C) 2015 AACR.