title: [Risk of cervical cancer and precancerous diseases in the oral HPV carriers].
abstract: OBJECTIVE
  To evaluate the risk of the occurrence of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer in the oral HPV carriers through a population-based investigation in Shanghai.
  
  
  METHODS
  A total of 1200 cases of outpatients who attended the annual cervical examination and 50 preoperational cases of inpatients with CINIII or invasive cervical cancer were enrolled from three clinical centers in Shanghai. The oral HPV infection was determined by real-time PCR. In 1200-case cross-sectional study, the incidence rate of CIN was compared between the oral HPV positive and negative cohort. In 1250-case case-control study, the positive rate of oral HPV DNA test was compared among normal control group, CINI-III, and invasive cancer case groups, and all odds ratio (OR) values were calculated, respectively. The HPV transmission-related demographic and behavioral characters of the oral HPV carriers were also analyzed.
  
  
  RESULTS
  The oral HPV carriers accounted for 5.9% (71/1200) of the investigated outpatients. The oral HPV DNA positive rates were gradually increased with the cervical disease grades, which were 5.8% (68/1182, normal), 2/13 (CIN I), 1/5 (CINII), 31.4% (11/35, CINIII) and 5/15 (invasive cancer). In cross-sectional cohort studies, the relative risks (RR) of CINI,II were 2.9 and 4.0 for oral HPV carriers, respectively. In case-control study, the OR values for CINI-III and invasive cervical cancer were 3.1(95%CI: 1.6-10.1), 4.2(95%CI: 1.7-28.4), 7.1(95%CI: 4.8-19.8) and 10.1(95%CI: 3.2-32.1), respectively. The oral sex and multi-sexual partner were two major risk factors for the oral and cervical HPV co-infection, HPV-related cervical cancer and precancerous diseases according to behavioral analysis.
  
  
  CONCLUSIONS
  There are complicated transmission pathways between oral and cervical HPV. Oral HPV carriers should be intensively followed up and their oral HPV infection and HPV-related cervical diseases should be treated together.
authors.affiliation: Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Jiaotong University, Shanghai 200127, China.
authors.forename: Yi-feng
authors.initials: YF
authors.lastname: He
authors.forename: Mei-ying
authors.initials: MY
authors.lastname: Zhang
authors.forename: Ling-da
authors.initials: LD
authors.lastname: Feng
authors.forename: Yi-hua
authors.initials: YH
authors.lastname: Yin
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.forename: Wen
authors.initials: W
authors.lastname: Di
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000821:virology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006801:Humans; D009055:Mouth / Q000821:virology; D009059:Mouth Diseases / Q000453:epidemiology / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission* / Q000821:virology; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000821:virology; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology
chemical_list: D004279:DNA, Viral