While many spouses of patients diagnosed with human papilloma virus (HPV)-positive oropharyngeal cancer (OPC) have anxiety over their own HPV-related cancer risk, a new study finds that spouses were no more likely to test positive for oral HPV infection than people in the general population.

The Human Oral Papillomavirus Transmission in Partners over Time (HOTSPOT) study is the first large study to examine oral HPV infection among patients with HPV-caused oropharyngeal cancer and their spouses.

This study confirms that couples who have been together for several years do not need to change their intimacy or sexual behavior because of the cancer diagnosis.

HPV infection is very common among men and women in the U.S., but the overwhelming majority of individuals with the infection will not get cancer.

The incidence of HPV-positive head and neck cancers, however, has increased significantly over the past 20 years, particularly among non-Hispanic, white U.S. men.

“Patients with HPV positive oropharyngeal cancers and their spouses often worry about oral HPV transmission and wonder about the spouses’ cancer risk.

These findings provide assurance that prevalence of oral HPV infection is not increased among partners and their risk of HPV- OPC remains low,” said lead study author Gypsyamber D’Souza, PhD, MPH, MS, an associate professor of epidemiology at Johns Hopkins University in Baltimore, Md. “Couples who have been together for several years have likely already shared whatever infections they have and no changes in their physical intimacy are needed.”

The study included 147 individuals with HPV-OPC and 83 spouses/partners. The OPC patients were predominantly male and partners predominantly female.

The median age of OPC patients in this study was 56 years. Oral HPV DNA was collected through a 30-second mouth rinse and gargle at diagnosis and again one year later. The oral rinse samples were tested for 36 different subtypes of HPV, including HPV16, the type responsible for most HPV-OPC cases as well as a variety of other cancers.

HPV DNA was detected in 66 percent of HPV-OPC patients at diagnosis but only 7 percent of those patients still had oral HPV infection one year later, after having gone through cancer treatment. The overall prevalence of oral HPV among partners was 7.2 percent. The prevalence among the 75 female partners was 5 percent, which is comparable to the prevalence among women in the general population (4 percent, based on previously published data).

The prevalence among the small number of male partners assessed in this study was also similar to that among men in the general population, though higher than in the female population. HPV16, the subtype responsible for most cases of HPV-OPC, was detected in 54 percent of HPV-OPC patients but in only 2.7 percent of female partners and in none of the male partners. Taken together, the researchers stated that the findings provide reassurance for both female and male partners that their risk of developing HPV-OPC remains low. No pre-cancers or cancers were detected in the 64 percent of partners that underwent a visual oral exam.

“HPV, the human papillomavirus, is responsible for thousands of cases of cancer of the oropharynx, cervix, and other sites every year. This study improves our understanding of HPV risk among the partners of patients with HPV-positive oropharyngeal cancers. I’m sure this news will provide long-awaited reassurance for patients as well as their spouses and partners,” said Gregory Masters, MD, ASCO spokesperson and head and neck cancers expert.
Researchers emphasized, however, that to better understand oral HPV transmission more couples research is needed among young adults.
This research was supported by the Johns Hopkins Innovation Fund, Richard Gelb Cancer Prevention Award.

Source: ASCO