Post Doc project: Lisa Maatekor Caulley

Oral HPV: Tackling the Next Epidemic

HPV infection has caused an epidemic increase in the incidence of OPCs. HPV is the most common sexually transmitted infection. HPV infection is estimated to result in 5.6 to 16.5 infections per 1000 person-months, with higher incidence rates observed in college students and young adults compared to older adults. HPV can infect the upper airways and is causally associated with benign diseases, including recurrent respiratory papillomatosis (RRP), and malignant disease, including OPCs. There are no population-based studies of the incidence or prevalence of RRP, their infectivity or clinical course, underscoring a need for further studies in this domain. Persistent RRP also carries a risk of malignant transformation. The incidence of HPV-OPCs has risen in correlation with increased oral HPV prevalence. By 2030, OPCs is expected to constitute 47% of all head and neck cancers. There are no approved approaches for prevention and early detection of OPC, thus leading patients to present with advanced cancers requiring extensive therapies with significant side effects and cost to the healthcare system.

This study will quantify the burden of disease secondary to oral human papillomavirus (HPV) infection by sex and age, and evaluate strategies, including gender-neutral vaccination programs, for prevention and early detection of resultant disease. To investigate and evaluate public health strategies in oral HPV infection through: 1) A systematic review of the literature of oral HPV infection and resultant disease; 2)To establish the annual trend in HPVoropharyngeal carcinomas (OPCs); 3)To establish the economic burden of HPV-related oral infections and resultant disease; 4)To model the historical and projected lifetime risk of benign and malignant HPV-related diseases on a population-level; 5)To model the impact and cost-effectiveness of preventative strategies on HPV-related oral infections and resultant disease.