Derby study first in UK to examine rates of common oral infection which can cause mouth cancer

Researchers at the University of Derby have carried out the first UK pilot study examining rates of a common oral infection in young healthy adults that can cause cancer in the mouth. The innovative study questioned 124 people aged 18-24 about their lifestyle and took mouth swabs, revealing that 4% had a detectable oral HPV infection. The questionnaires indicated that lifestyle choices, such as smoking, could possibly increase the risk of contracting HPV.

What is HPV?

Human Papilloma Virus (HPV) is a common viral infection which can be passed on through close contact. It has high-risk strains that can lead to head and neck and cervical cancers. HPV infections are spread via touch and the types of HPV that affect the mouth and throat may also be passed on through certain behaviours such as oral sex.

There are more than 100 types of HPV and most people have the virus at some point in their lives. However, some high-risk strains can cause cancer if that person remains infected for a long time. Cervical cancer is the most common cancer caused by HPV but the infection can also cause head and neck, anal, penile, skin and, possibly, oesophageal cancer.

Why was research needed?

Dr Gillian Knight, Head of Biosciences at the University of Derby, who led the study, said:

HPV is a very common infection, with around 80% of adults being exposed to a genital HPV infection by their mid-twenties. We already know that this high infection rate influences the likelihood of women developing cervical cancer, but what we don’t know is how many people who have an oral HPV infection go on to develop HPV head and neck cancer.

In the UK, we only vaccinate 12-13 year old girls with the HPV jab to prevent them from picking up the high-risk strains of HPV when they become sexually active, which hopefully will prevent in girls all HPV-related cancers, including cervical cancer.

We do not vaccinate boys even though they have the same risk of contracting HPV infection as women and a recently identified risk – higher than in women – of head and neck cancer. Patients presenting at head and neck clinics with HPV-associated cancers are steadily increasing, particularly in white males under the age of 40.

The reason why men in the UK are not given the vaccine is that rates of HPV head and neck cancer are currently not as high as cervical cancer rates, but as the numbers of HPV head and neck cancer increase, there is a call that the UK follow other countries and start to vaccinate their boys.

The research project

Dr Knight conducted a lifestyle questionnaire among young people – a cohort determined to be at high risk of contracting genital HPV infection – to establish the prevalence of the virus among young adults. The survey focused on drinking and smoking habits, relationship status, sexual orientation and number of sexual partners. The participants also submitted a mouth swab which was screened for HPV detection.

The results showed that 4% had a detectable HPV infection – with the majority of them being smokers. Although the number of infected individuals was small, the key findings of the pilot study align with other studies conducted within the US which indicate that oral HPV may be spread by sexual practices and that smoking can also influence oral HPV infection.

Following the research project

As part of the future research at the University of Derby, we are working with the Royal Derby Hospital to investigate the rates of HPV infection in patients attending head and neck clinics to determine the rates of oral HPV infection in a wider age range.

To help raise awareness of the virus, a free public lecture was held in November 2016 where Dr Knight explained in detail what HPV is, how it plays an important role in cervical cancer and head and neck cancers and why parents should be better educating their children about this virus.

Dr Knight explains why men should be asking for the cervical cancer vaccination:

A talk by our Head of Biosciences, Dr Gillian Knight, on research into HPV and how the common virus turns cancerous