The overall prevalence of oral human papillomavirus infection is approximately 7% among U.S. men and women ages 14 to 69, while the prevalence among men is higher than among women, according to a study.

Maura L. Gillison, MD, PhD, of the Ohio State University Comprehensive Cancer Center in Columbus, and colleagues examined the prevalence of oral HPV infection in the United States. The researchers used data from a cross-sectional study as part of the National Health and Nutrition Examination Survey 2009-2010, a statistically representative sample of the U.S. population. Men and women ages 14 to 69 examined at mobile examination centers were eligible.

The researchers found that the overall prevalence of oral HPV infection was 6.9%, and the most prevalent HPV type detected was HPV16 (1%), which causes at least 90% of HPV-positive oropharyngeal squamous cell carcinomas, according to the researchers.

"The incidence of OSCC has significantly increased over the last three decades in several countries, and HPV has been directly implicated as the underlying cause," the authors wrote.

The prevalence of oral HPV infection had peaks in different age ranges, with a first peak in prevalence observed among those ages 30 to 34 (7.3%) and a second, higher peak among those ages 60 to 64 (11.4%). Men had a significantly higher prevalence than women for overall oral HPV infection (10.1% vs. 3.6%). Prevalence of HPV was higher among current smokers and heavy alcohol drinkers and among former and current marijuana users.

The authors also found that oral HPV prevalence was associated with several measures of sexual behavior, including higher prevalence among individuals who reported ever having had sex vs. not (7.5% vs. 0.9%). Prevalence of HPV increased with lifetime or recent number of partners for any kind of sex.

In analysis inclusive of individuals ages 14 to 69, factors independently associated with prevalent oral HPV included age, sex, lifetime number of sexual partners and current number of cigarettes smoked per day.

The researchers wrote that their data provide evidence that oral HPV infection is predominantly sexually transmitted and "together, these data indicate that transmission by casual, nonsexual contact is likely to be unusual."

"Our results have important research as well as public health implications," they concluded. "Natural history studies of oral HPV infection are … necessary to understand the effects of age, sex and modifiable risk factors (e.g. smoking and sexual behavior) on the incidence and duration of oral HPV infection."

Vaccine efficacy against oral HPV infection "is unknown, and therefore vaccination cannot currently be recommended for the primary prevention of oropharyngeal cancer," the authors wrote, but vaccine trials may be warranted. "Such trials could inform ongoing discussions regarding the benefits of HPV vaccination for males, given the higher prevalence of oral HPV infection demonstrated here as well as higher incidence of HPV-positive OSCC among men."

The study appeared Thursday on the website of JAMA in conjunction with presentation at the Multidisciplinary Head and Neck Cancer Symposium. To read it, visit http://bit.ly/woNXBE.