title: NHANES 2009-2012 Findings: Association of Sexual Behaviors with Higher Prevalence of Oral Oncogenic Human Papillomavirus Infections in U.S. Men.
abstract: The incidence of human papillomavirus (HPV)-positive oropharyngeal cancers is higher and increasing more rapidly among men than women in the United States for unknown reasons. We compared the epidemiology of oral oncogenic HPV infection between men and women ages 14 to 69 years (N = 9,480) within the U.S. National Health and Nutritional Examination Surveys (NHANES) 2009-2012. HPV presence was detected in oral DNA by PCR. Analyses were stratified by gender and used NHANES sample weights. Oral oncogenic HPV prevalence was higher among men than women (6.6% vs. 1.5%, P < 0.001), corresponding to 7.07 million men versus 1.54 million women with prevalent infection at any point in time during 2009-2012. Prevalence increased significantly with age, current smoking, and lifetime number of sexual partners for both genders (adjusted Ptrend < 0.02). However, men had more partners than women (mean = 18 vs. 7, P < 0.001). Although oncogenic HPV prevalence was similar for men and women with 0 to 1 lifetime partners, the male-female difference in prevalence significantly increased with number of lifetime partners (adjusted prevalence differences for none, 1, 2-5, 6-10, 11-20, and 20+ partners = 1.0%, 0.5%, 3.0%, 5.7%, 4.6%, and 9.3%, respectively). Importantly, the per-sexual partner increase in prevalence was significantly stronger among men than among women (adjusted synergy index = 3.3; 95% confidence interval, 1.1-9.7), and this increase plateaued at 25 lifetime partners among men versus 10 partners among women. Our data suggest that the higher burden of oral oncogenic HPV infections and HPV-positive oropharyngeal cancers among men than women arises in part from higher number of lifetime sexual partners and stronger associations with sexual behaviors among men.
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, Maryland.
authors: Anil K
authors: AK
authors: Chaturvedi
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, Maryland.
authors: Barry I
authors: BI
authors: Graubard
authors: The Ohio State University, Columbus, Ohio.
authors: Tatevik
authors: T
authors: Broutian
authors: The Ohio State University, Columbus, Ohio.
authors: Robert K L
authors: RK
authors: Pickard
authors: The Ohio State University, Columbus, Ohio.
authors: Zhen-Yue
authors: ZY
authors: Tong
authors: The Ohio State University, Columbus, Ohio.
authors: Weihong
authors: W
authors: Xiao
authors: Information Management Services, Calverton, Maryland.
authors: Lisa
authors: L
authors: Kahle
authors: The Ohio State University, Columbus, Ohio. Maura.gillison@osumc.edu.
authors: Maura L
authors: ML
authors: Gillison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology* / Q000821:virology*; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology; D055815:Young Adult