Exploring lay public and dental professional knowledge around HPV transmission via oral sex and oral cancer development

Transmission and clearance of human papillomavirus infection in the oral cavity and its role in oropharyngeal carcinoma - A review

The majority of sexually active individuals becomes infected with human papillomavirus (HPV) at least once in their lifetime. Pathways for HPV transmission vary across different mucosal sites per individual. They include autoinoculation within one host, direct transmission between individuals (including perinatal transmission and transmission during sexual activity), and indirect transmission through contact with hands. The authors aim to clarify the prevalence and route of transmission per anatomic site, inter- and intra-individually, using a narrative review of the literature. In conclusion, transmission of HPV to the oral cavity and oropharynx is hypothesised to occur mainly through sexual contact. Transmission of particles through saliva has not been proven and daily living activities are not a documented source of HPV infection. Oropharyngeal HPV related cancer survivors and their partners do not show increased risk of infection during sexual intercourse. Transmission of HPV to the oral cavity (autoinoculation with fingers or transmission through saliva in deep kissing) is probably of limited importance.

Sexual Behavior and the Awareness Level of Common Risk Factors for the Development of Cervical, Anogenital and Oropharyngeal Cancer among Women Subjected to HR HPV DNA-Testing

The human papillomavirus (HPV) is a significant health problem that increases the risk of developing precancerous lesions, cancer of the anogenital area, as well as mouth and throat cancers. The aim of the study was to analyze the awareness level of common risk factors and the preferred sexual behavior of women aged 18–68, who underwent a molecular evaluation of common HR-HPV from material collected from the cervix. The study was conducted at the Jan Kochanowski University in Kielce, Collegium Medicum, in the period from December 2019 to August 2020 on a group of 201 women. A diagnostic survey and the HR-HPV molecular test were used in the research. All of the obtained samples were subjected to identification of and testing for the presence of HR-HPV by the Cobas 4800 platform (Roche Diagnostic^©, Basel, Switzerland). We presented the statistically significant relationships between the age of the respondents and the awareness of the impact. The women aged over 43 years old presented the widest spectrum of information concerning HPV-related lesions. Conclusion: Our study highlights the necessity of educating women about the prevention of sexually transmitted infections.

Sexual practices and HPV infection in unvaccinated young adults

The present study aimed to evaluate the association of genital and oral HPV infection among different sexual practices in both sexes. In total, 6388 unvaccinated men and women aged 16–25 years from all state capitals of Brazil were enrolled in through primary care services between September 2016 and November 2017. Genital and oral HPV genotyping was performed using the Roche Linear Array. Poisson regression analysis with robust variance was conducted to examine factors associated with overall HPV infection. A higher prevalence of genital HPV was found in women who practiced oral sex (57.85%) and in men who practiced all types of sex (65.87%). However, having more sexual partners and being younger were more important than the type of sex practiced. HPV 6 (7.1%) and 16 (10.5%) were significantly more prevalent in women who practiced oral sex, while HPV 6 (23.96%) and 11 (21.49%) were more prevalent in men who practiced anal sex. The type of sex was not associated with oral HPV prevalence. Genital and oral HPV infection were not associated by different sexual practices in the studied population.

Data set and methodology involving pedagogical approaches to teach mental health and substance use in dental education

Objective

In this Data note, we provide a raw data set in the form of brief self-guided reflections. We also present the methodological approach to generate these reflections including an educational vignette so that other dental schools can plan for their teaching activities involving mental health and substance use topics.

Data description

Between 2015/16 and 2018/19, the University of British Columbia’s (UBC) undergraduate dental and dental hygiene students submitted optional written guided reflections to address ‘how can an educational vignette, depicting a patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?’ From a total of 323 undergraduate students, 148 anonymous reflections between 200 and 400 characters each were received. The main ideas that may emerge from the reflections include ‘exploring power relations’ and ‘patient-centered care approach to counteract stigma’.

Discussing HPV and oropharyngeal cancer in dental settings: gender and provider-type matter

Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and the leading cause of oropharyngeal cancer (OPC), an oral cancer most often identified by dental providers. Given the rise in HPV-associated OPC and recent Food and Drug Administration (FDA) approval of the HPV vaccine to prevent OPC, dental providers have a unique role in HPV prevention. This study assessed US adults' comfort levels discussing HPV and OPC with dental providers. An online survey platform was used to recruit a nationally representative sample of US adults (n = 300). The questionnaire assessed participants' knowledge, acceptability, and comfort discussing HPV-related topics with dental providers. SPSS 24 was utilized for data analyses. In general, participants reported feeling comfortable discussing HPV and OPC with dental providers. Participants reported feeling more comfortable with dentists than dental hygienists when discussing (t = 2.85, p < .01) and receiving recommendations about the HPV vaccine (t = 2.09, p < .05). Participants were less comfortable discussing HPV as a risk factor for OPC compared to non-HPV related risk factors (t = 2.94, p < .01). Female participants preferred female providers, whereas male participants had no preference. Previous research has indicated dental providers recognize their role in HPV prevention, but research is needed to understand patients' perceptions of dental providers' role in HPV prevention. Findings demonstrate that US adults are comfortable discussing HPV and OPC with dental providers, which may be key to OPC-HPV prevention. Future research is needed to facilitate HPV communication between patients and dental providers.

Prevalence of Human Papillomavirus (HPV) 16 and 18 in Oral Malignant and Potentially Malignant Disorders: A Polymerase Chain Reaction Analysis - A Comparative Study

Introduction:

Human papillomavirus (HPV) are now being increasingly associated as a cause of oral squamous cell carcinomas (OSCC). This study was designed to evaluate the prevalence of HPV in Pelizaeus-Merzbacher disease (PMD) and OSCC using polymerase chain reaction that might help in better understanding of the role played by this virus in the oncogenic process even from its evolution stage.

Materials and Methods:

Formalin-fixed paraffin-embedded tissue samples (n = 40) of OSCC and mild, moderate, and severe dysplasia were used for this study. DNA was quantified and checked for purity spectrophotometrically. Statistical analysis was performed using SPSS software and statistical significance was assessed using Fischer's exact test (p < 0.05 was considered significant).

Results:

High-risk (HR)-HPV-16 was found to be positive in 35% of OSCC cases which showed a statistically significant association of HPV 16 with OSCC. Verrucous carcinoma had predominant HPV 16 infection (60%), followed by SCC with 40%. However, this association was not statistically significant. None of the OSCC samples were infected with HPV 18. Among the PMD, we found only 5% showing HR-HPV 16 infection which was not significant.

Discussion:

Although OSCC is attributed to tobacco and alcohol consumption, a significant proportion of OSCC cases have been demonstrated to contain HPV types. The high-risk HPV type 16 tends to be the most predominant type detected in cases of OSCC.

Do Health-Seeking Populations Know the Link Between Human Papillomavirus and Oropharyngeal Cancer? A Cross-Sectional Study in a Nigerian Population

BACKGROUND

The human papillomavirus (HPV) has been causally linked to oropharyngeal cancers. The extent to which the population is aware of this link has not been explored in Nigeria. We aim to investigate the knowledge of the link between HPV and oropharyngeal cancers in a health-seeking population in Nigeria.Methodology: We used a cross-sectional study design, with a multi-stage sampling method comprising a cluster of four health facilities and first-time adult patients attending the general outpatient clinics of the selected health facilities. An interviewer-administered questionnaire was be used to obtain demographic information, social history, HPV awareness, HPV vaccination and the link between HPV and oropharyngeal cancer.

RESULTS

A total of 1,000 respondents completed the survey from four health facilities in Lagos, Nigeria. Majority of respondents were below 40 years (61.5%), and female (53.4%). About 13.4% of the study population were aware of HPV, and 7.9% of HPV vaccines. The most common source of HPV information for respondents who were aware of HPV was the internet (65.4%). Only 7.7% of respondents knew the link between HPV and oropharyngeal cancer. Significant predictors of knowledge of the link between HPV and oropharyngeal cancer were higher education [p: 0.012], higher overall knowledge of HPV risk factors and complications [p: 0.000]; and awareness of HPV vaccine [p: 0.020].

CONCLUSIONS

Our findings suggest a lack of public knowledge of the link between HPV and oropharyngeal cancer. These findings could inform health promotion measures for oropharyngeal cancer, particularly for groups where knowledge is lowest.

Oral health care professionals recommending and administering the HPV vaccine: Understanding the strengths and assessing the barriers

Introduction

Head and neck cancer is a deadly cancer that ranks among the six most common cancers worldwide. The HPV vaccine has been used to prevent head and neck cancer of the oropharynx, and changes in health policies and state law are impacting the role of dental professionals in HPV vaccination. However, relatively little is known about dental professionals’ attitudes regarding the vaccine.

Objectives

Our study assesses dental professionals’ willingness to administer the HPV vaccine, their confidence discussing HPV with patients, beliefs about the vaccine’s efficacy, perceived barriers to administering it, and sites of referral.

Methods

We surveyed 623 dental professionals, including dentists, hygienists, dental students, and hygiene students across Michigan. Attitudes toward the vaccine and predictive characteristics were evaluated by logistic regression, ANOVAs, and t-tests.

Results

The majority of the respondents (51% of dentists, 63% of hygienists, 82% of dental students, and 71% of hygiene students) were willing to administer the HPV vaccine if allowed by law. The role of dental and dental hygiene students would be one of advocacy, educating and recommending the vaccine, and the dental students administering it once licensed. Dental professionals were variably confident discussing HPV with patients and generally believed it enhanced patients’ health. Stronger confidence and beliefs were associated with greater willingness to administer the vaccine. Barriers among professionals opposing the HPV vaccine included lack of knowledge on the subject, liability concerns, and personal beliefs.

Conclusion

Dental professionals can become leaders in preventing HPV-related cancers. Training and continuing education courses could enhance their confidence and willingness to recommend and administer the HPV vaccine.

Policy implications

Legislation that permits dental professionals to administer the vaccine could increase the vaccine’s accessibility to patients, improve vaccination rates, and population health.

Human papillomavirus and oral health

Canada is among the world leaders in oral health. Despite this, there are growing concerns about the rising rates of HPV-related mouth and throat cancers. The link between human papillomavirus (HPV) and cervical cancer is well established; fortunately, thanks to detection and vaccination, Canada has one of the lowest incidence rates of cervical cancer in the world. The HPV-related mouth and throat cancers, however, present a different picture. In Canada, about 25% to 35% of mouth and throat cancers are related to oral HPV infection; and in 2012, the incidence rate of HPV-associated oropharyngeal cancer was more than 4.5 times higher in males than females. Furthermore, HPV vaccination uptake in Canada is higher among females than males. Physicians and nurses in public health and clinical settings have a role to play in the fight against HPV transmission, as do oral health professionals. Oral health professionals can play a key role in preventing HPV infection and HPV-related oropharyngeal cancers by raising awareness, educating and offering counselling to their clients, and promoting evidence-based preventive and diagnostic interventions.

A Snapshot of Knowledge about Oral Cancer in Italy: A 505 Person Survey

Objectives: Patients' knowledge about oral squamous cell carcinoma (OSCC) plays an important role in primary prevention, early diagnosis, and prognosis and survival rate. The aim of this study was to assess OSCC awareness attitudes among general population in order to provide information for educational interventions. Methods: A survey delivered as a web-based questionnaire was submitted to 505 subjects (aged from 18 to 76 years) in Italy, and the answers collected were statistically analyzed. Information was collected about existence, incidence, features of lesions, risk factors of oral cancer, and self-inspection habits, together with details about professional reference figures and preventive behaviors. Results: Chi-square tests of independence with adjusted standardized residuals highlighted correlations between population features (age, gender, educational attainment, provenance, medical relationship, or previous diagnoses of oral cancer in family) and knowledge about oral cancer. Conclusions: Knowledge about OSCC among the Italian population is limited, and it might be advisable to implement nudging and sensitive customized campaigns in order to promote awareness and therefore improve the prognosis of this disease.