PREVALENCE AND DETERMINANTS OF ORAL HPV INFECTION IN THE US POPULATION

描述(由申请人提供)：口腔HPV16感染是口咽癌的既定原因，口咽癌在美国的发病率正在上升，特别是在年轻的白人男性中。口腔HPV16感染会使口咽癌风险增加约15倍，并对公共卫生产生明显的影响。然而，人们对口腔HPV感染的流行病学几乎一无所知。我们的目标是在具有代表性的美国人口样本中确定口腔HPV感染的流行率和决定因素(例如人口、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解释这些因素导致的口腔HPV流行模式，以及在美国观察到的HPV相关和非HPV相关HNSCC的发病模式。我们已经开发和验证了检测口腔HPV感染的方法，并展示了我们随着时间的推移重复检测感染的能力。我们已与国家卫生统计中心、国家癌症研究所和疾病控制与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岁的参与者进行了一项嵌套的横断面研究，该调查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，以招募实现我们目标所需的样本量：(1)确定美国人口中HPV感染的流行率和类型分布；(2)确定与感染独立相关的人口、行为和健康因素；(3)按年龄、性别、种族和出生队列评估与口腔HPV感染和HNSCC相关的因素(例如，性行为、吸烟、饮酒、使用大麻)的分布，并将这些因素与美国人口中HPV相关和非HPV相关的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目前针对男孩的HPV预防性疫苗政策的公共政策或实践，并将对未来通过接种疫苗预防或筛查口腔HPV感染的HNSCC的初级预防产生影响。

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.