Finnish study finds oral health worse in oropharyngeal cancer patients with HPV than oral tongue cancer patients

HELSINKI, Finland: Human papillomavirus (HPV) causes roughly 2% of oral cavity or laryngeal cancers and 31% of oropharyngeal cancers, according to a Lancet Global Health Study. Based on the prevalence of these cancers, a study conducted by researchers at the University of Helsinki and Helsinki University Hospital has compared the oral health of patients with a diagnosis of oropharyngeal squamous cell carcinoma (OPSCC) and the human papillomavirus (HPV) and of OPSCC but not HPV and those diagnosed with oral tongue squamous cell carcinoma (OTSCC). It found worse oral health in the OPSCC patients.

Though the causes remain unclear, and the differences were slight, there was enough evidence for the researchers to recommend further investigation in this regard.

The original hypothesis of the team was that patients with OTSCC would have a worse oral health score. This hypothesis was based on previously documented evidence of associations between oral infections and poor oral hygiene, as well as correlations between poor oral hygiene and the number of extracted teeth and incidence of HPV.

The findings indicated that, compared with OPSCC patients who were HPV-negative and with patients with OTSCC, HPV-positive OPSCC patients had a higher periapical lesion index. More OPSCC patients had removable prostheses in comparison with OTSCC patients. The OPSCC patients tended to have dramatically higher TNM stage (a system used to assess cancer extent) and tumour grading. The researchers were surprised that the overall oral health of the OPSCC patient group was worse even though previous cancer and tumour diagnoses were more common in the OTSCC patients, which the researchers assumed could be attributed to more comorbidities related to tobacco and alcohol use.

Out of the OPSCC group of 55, 21 had an HPV-positive tumour and 24 had an HPV-negative tumour. The researchers noted that the proportion of HPV-induced carcinomas could account for the primary difference in risk factors between OPSCC and OTSCC. The team also predicted a reduction in OPSCC cases owing to lower future rate of infections with HPV thanks to the growing rate of HPV vaccinations in Finland. They cautioned however that there are many people in age groups not vaccinated against HPV that are at risk of developing HPV-related cancer and focus should be on early detection of these.

Because of the retrospective nature of the study, information was missing for a number of patients, limiting the sample size.

The study, titled “Dental health in patients with and without HPV-positive oropharyngeal and tongue cancer”, was published on 22 September in PLOS ONE.


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