ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Increased Prevalence of Oral HPV in Saliva of Women with HPV-Positive Cervical Lesions
Clinical Question In women with cervical cancer as compared to healthy women, are salivary biomarkers an effective method of detecting significant undiagnosed oral human papilloma virus infection?
Clinical Bottom Line In women with HPV-positive cervical lesions, the prevalence of oral HPV in the saliva samples is greater than in saliva samples from women with no HPV cervical lesions.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 27570540Visalli/2016100 women with cervical HPV lesions and 25 healthy women (controls) Case control study
Key results“The prevalence of oral HPV infection in saliva samples was 24% in women with HPV cervical lesions while in the control group was 8%. It has been demonstrated a strong association between high grade squamous intraepithelial lesion and oral infection due to HPV16 and 18, that are the most frequently detected HPV genotypes.” In addition this study “highlights that women with a prior histopathologic diagnosis of cervical HPV are at high risk for subclinical oral HPV, as indicated by the presence of the virus in the oral cavity of 24% of the patients.” Furthermore, “Analyzing the data of saliva HPV positivity and cervical clinical data we revealed a correspondence of genotypes between saliva and cervix in case of infections by HPV 16 and 18 supported by a significant increase of saliva HPV positivity in women with high-grade cervical lesions (P = 0.0069; OR = 3.747; 95 % CI: 1.39–10.09).”
Evidence Search HPV; oral cancer; cervical cancer; saliva
Comments on
The Evidence
Validity: This case control study had women in each group, control and test groups, with similar age ranges; none of the women were vaccinated for HPV and none of the women had oral lesions. Saliva samples were collected from the women in each group in a similar controlled manner. The likelihood of participant recall bias due to self-reported data could have occurred in this case control study. The participants may or may not have been completely honest in their reporting of behavioral factors. The authors of this study reported no conflicting interests, and ethics of approval and consent by participants of this study were followed. Perspective: The importance of early detection as well as prevention is an important part of a general dentist’s job. It would be beneficial to patients to detect salivary levels of HPV before oral lesions are present using a simple in-office salivary test, so that preventative methods can be taken.
Applicability Rising research has given general dentists methods of detection of HPV in the oropharynx in women patients with HPV-positive cervical cancers. Patients coming in for dental treatment should be screened for oral cancers via head and neck physical examination as well as through salivary testing to assess risk for possible oral HPV infection.
Specialty/Discipline (Public Health) (General Dentistry)
Keywords HPV; oral cancer; cervical lesions; saliva
ID# 3211
Date of submission: 04/13/2017spacer
E-mail salinasbl@livemail.uthscsa.edu
Author Britta Salinas
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Juanita Lozano-Pineda, DDS, MPH
Faculty mentor/Co-author e-mail pinedaj@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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