Study confirms smoking, oral sex as HPV risk factors

By Tony Edwards, DrBicuspid.com editor in chief

August 23, 2018 -- Smoking and certain sexual behaviors are risk factors for human papillomavirus (HPV) infection, a new study has confirmed. However, the researchers found that the infection rates of high-risk HPV oral infection were lower than expected in a region of England outside of London.

The study of almost 700 men and women found a low infection rate of 2.2%. The participants with oral high-risk HPV infection were more likely to be former smokers and had a greater number of sexual and oral sex partners, the researchers reported in BMJ Open (August 17, 2018).

"This is the first study in the north of England and [it] found lower rates of oral high-risk human papillomavirus infection," stated lead author Vanessa Hearnden, PhD, in a University of Sheffield press release. Dr. Hearnden is a lecturer in biomaterials and tissue engineering in the department of materials science and engineering at the University of Sheffield in the U.K.

Lifestyle risk factors

The researchers conducted the observational study to determine the prevalence of and associated risk factors for infection with oral high-risk HPV in adults in the north of England.

The study included 700 men and women who completed a lifestyle and sexual behavior questionnaire. The participants, ages 18 to 60, also provided an oral rinse-and-gargle sample for the detection of high-risk HPV.

“This study confirms the importance of lifestyle risk factors in prevention of the disease.”
— Kate Allen, PhD

Just over 400 of the participants had never smoked, while more than 290 participants were a current or past smoker. Of the current or former smokers, nine (about 3%) were diagnosed with high-risk HPV infection, while six (about 1.4%) of those who had never smoked had a similar diagnosis.

The researchers also asked participants about their number of sexual and oral sex partners. Of the more than 330 participants with five or fewer sexual partners, two were diagnosed with HPV infection. Six of more than 170 participants (about 3.4%) with between six and 10 sexual partners were diagnosed with the infection. Of the more than 150 participants with 11 or more sexual partners, seven (4.4%) were diagnosed with HPV.

Similar results were found when respondents were asked about their oral sex partners. Five of almost 500 of those with up to five oral sex partners were HPV-positive, compared with eight of almost 110 participants (7.3%) with between six and 10 oral sex partners and two of 85 (2.4%) of those with 11 or more partners.

Self-reported behaviors

The authors noted several possible study limitations:

  • The HPV detection methods used were limited in number.
  • The low prevalence of infection may offer only a limited ability to confidently determine risk factors.
  • Self-reported sexual, smoking, and alcohol behaviors were collected using nonvalidated questionnaires and so may not be accurate.

Nevertheless, the study findings highlight the need to make the population aware of lifestyle risk factors, according to Kate Allen, PhD, the executive director of science and public affairs for World Cancer Research Fund International.

"This study confirms the importance of lifestyle risk factors in prevention of the disease and sheds new light on the rates of oral [high-risk] HPV infection in England," Dr. Allen stated in the University of Sheffield release.



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