This proposed study will build upon ongoing bi-institutionally funded prospective cohort studies of adults at high-risk for human papillomavirus (HPV)-related cancers, especially HPV-related oropharyngeal cancer (OPC). HPV-related OPC is the most common HPV-related cancer, is projected to rise in incidence over the next several decades despite ongoing vaccination efforts, is predominantly caused by the HPV16 strain, and primarily affects men compared to women (~6:1 ratio) at middle- and elderly ages. Oral HPV16, HPV16 early (E) antigen antibodies and circulating HPV16 DNA (cHPVDNA) are valid biological markers of HPV-related disease. This proposal will fund the development of the largest kno...
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This proposed study will build upon ongoing bi-institutionally funded prospective cohort studies of adults at high-risk for human papillomavirus (HPV)-related cancers, especially HPV-related oropharyngeal cancer (OPC). HPV-related OPC is the most common HPV-related cancer, is projected to rise in incidence over the next several decades despite ongoing vaccination efforts, is predominantly caused by the HPV16 strain, and primarily affects men compared to women (~6:1 ratio) at middle- and elderly ages. Oral HPV16, HPV16 early (E) antigen antibodies and circulating HPV16 DNA (cHPVDNA) are valid biological markers of HPV-related disease. This proposal will fund the development of the largest known cohort of middle-aged men with biomarkers of HPV-related infection, pre-cancer or cancer. This will allow us to better understand the natural history of HPV, specifically oral HPV, in middle-aged adults, which is a key barrier to advancing HPV-related cancer prevention strategies. In our first goal, using data collected from this cohort, we will determine the association of HPV16 E antibodies and/or cHPVDNA with oral HPV16 DNA prevalence. In our second goal, we will determine the association of HPV16 E antibodies and/or cHPVDNA with oropharyngeal and anogenital HPV16 DNA prevalence, persistence, pre-cancer and cancer. In our third goal, we will determine the association of 12-month persistence of oral rinse HPV16 DNA with oropharyngeal subsite-specific (left tonsil, right tonsil, and base of tongue) HPV16 DNA prevalence, pre-cancer and cancer. Finally, we will explore the use of a blood-based point-of-care assay to determine serologic status. Study results will facilitate: 1) an improved understanding of the natural history of HPV; 2) advances in the development of a comprehensive national HPV-related OPC screening trial; and 3) establishment of a cohort of individuals eligible for other future prevention trials, including therapeutic vaccination.
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