Interplay between human papillomavirus infection, cervical cancer history, and the incidence of oral cancer: A cohort study

Abstract

Background: Human papillomavirus (HPV) is a well-established primary etiological factor involved in cervical cancer oncogenesis. Recent research has also identified HPV as a significant contributor to head and neck cancers, including oral cancer. This study aimed to investigate the influence of high-risk cervical HPV infection on oral carcinogenesis.

Methods: This retrospective, observational cohort study employed data from the Kangbuk Samsung Health Study. Female participants aged over 30 years with high-risk HPV test results were enrolled between 2011 and 2021. Variables analyzed included health behaviors, high-risk cervical HPV infection, previous cancer history, and familiar cancer history. The primary outcome was the incidence of oral cancer. The adjusted hazard ratio (HR) for oral cancer was obtained using Cox proportional hazard regression analysis.

Results: This study included 100,643 females with high-risk HPV positivity in 8998 females, corresponding to a prevalence of 8.9 %. The incidence rate of oral cancer was low, at 0.022 %. Menopause, alcohol consumption, prior cancer history, especially uterine cervical cancer, and familiar history of cancer, particularly for uterine cervical cancer significantly influenced the occurrence of oral cancer. High-risk HPV positivity alone was not significantly associated with oral cancer (HR, 1.796; 95 % CI, 0.403 - 8.002). Nevertheless, oral cancer was significantly related with a history of uterine cervical cancer (HR, 15.915; 95 % CI 3.366 - 75.252).

Conclusion: Cervical high-risk HPV infection alone may not significantly impact the incidence of oral cancer, but its role in carcinogenesis could be substantial when combined with other confounding factors, such as a previous uterine cancer history.