PREVALENCE AND DETERMINANTS OF ORAL HPV INFECTION IN THE US POPULATION

描述（由申请人提供）：口腔HPV16感染是口咽癌的确定原因，口咽癌是美国发病率上升的一种癌症，特别是在年轻的白人男性中。口服HPV16感染使口咽癌风险增加约15倍，并具有明显的公共卫生后果。然而，对口腔HPV感染的流行病学几乎一无所知。我们的目标是确定美国人口中口腔HPV感染的患病率和决定因素（例如人口统计学，行为和健康因素）。我们假设年龄、性别、种族和出生队列的性行为差异将通过这些因素解释口腔HPV患病率的模式，以及在美国观察到的HPV相关和非HPV相关HNSCC的发病率模式。我们已经开发并验证了检测口腔HPV感染的方法，并证明了我们随着时间的推移可重复检测感染的能力。我们与国家卫生统计中心、国家癌症研究所和疾病控制和预防中心建立了合作关系，在2009-2010年国家健康和营养检查调查（NHANES）中对14至69岁的参与者进行了口腔HPV感染的嵌套横断面研究，这是一项以人群为基础的研究，旨在评估美国人口的健康和营养状况。我们现在寻求支持，将这项研究延长到2014年，以招募必要的样本量来实现我们的目标，这是：(1)确定美国人群中口腔HPV感染的患病率和类型分布；(2)确定与感染独立相关的人口、行为和健康因素；(3)根据年龄、性别、种族和出生队列评估口腔HPV感染和HNSCC相关因素（如性行为、烟草使用、酒精使用、大麻使用）的分布，并将其与美国人群中HPV相关和非HPV相关HNSCC的发病率模式进行比较。通过实现这些目标，我们将澄清口腔HPV感染的流行病学，估计美国人口中HPV相关HNSCC的风险比例，并确定高危出生队列。我们的研究结果可能会影响公共政策或关于目前男孩HPV预防性疫苗政策的实践，并将对通过接种疫苗预防或筛查口腔HPV感染来预防HNSCC的一级预防具有未来的意义。

DESCRIPTION (provided by applicant): Oral HPV16 infection is an established cause of oropharynx cancer, a cancer rising in incidence in the United States (U.S.), particularly among young, white men. Oral HPV16 infection confers an approximate 15-fold increased oropharynx cancer risk and has clear public health consequences. Yet, virtually nothing is known about the epidemiology of oral HPV infection. Our goal is to determine the prevalence and determinants (e.g. demographic, behavioral and health factors) of oral HPV infection in a representative sampling of the U.S. population. We hypothesize that differences in sexual behaviors by age, gender, race and birth cohort will account for patterns in oral HPV prevalence by these factors as well as for observed incidence patterns for HPV-related and HPV-unrelated HNSCC in the U.S. We have developed and validated methods for detection of oral HPV infection and demonstrated our ability to reproducibly detect infection over time. We have an established collaboration with the National Center for Health Statistics, the National Cancer Institute, and the Center for Disease Control and Prevention to perform a nested, cross-sectional study of oral HPV infection among 14 to 69 year old participants in the National Health and Nutrition Examination Survey (NHANES) 2009-2010, a population-based study designed to assess the health and nutritional status of the U.S. population. We now seek support to extend this study through 2014 to enroll the sample size necessary to achieve our aims, which are: (1) to determine the prevalence and type distribution of oral HPV infection in the U.S. population; (2) to identify demographic, behavioral and health factors independently associated with infection; (3) to evaluate the distribution of factors associated with oral HPV infection and HNSCC (e.g. sexual behavior, tobacco use, alcohol use, marijuana use) by age, gender, race and birth cohort and compare these to incidence patterns for HPV-related and HPV-unrelated HNSCC in the U.S. population. By accomplishing these aims, we will clarify the epidemiology of oral HPV infection, estimate the proportion of the U.S. population at risk for HPV-related HNSCC and identify birth cohorts at high risk. Our results may affect public policy or practice with regard to current HPV prophylactic vaccine policy for boys and will have future implications for the primary prevention of HNSCC via vaccination to prevent or screening to detect oral HPV infection.