The Prevalence of High-Risk Oral HPV Among Rural/Tribal Women In Mysore Who Are Chronic Smokeless Tobacco Users

Abstract

Background: Human papillomavirus (HPV) is the most common sexually transmitted virus. Low-risk HPV can cause warts, and the virus often clears on its own. High-risk HPV can persist and can cause cervical, anogenital, and head and neck cancer, primarily of the oropharynx. Not all oral cancers are caused by HPV alone. Additional independent risk factors include alcohol, smoking, and smokeless tobacco consumption. Tobacco use, including cigarette smoking and tobacco chewing, is the primary cause of oral cancer worldwide. India has high prevalence of tobacco consumption and 60% of smokeless tobacco users are women. Tobacco users have a fifteen-fold increased risk of oral cancer compared to non-tobacco users. There may be interactions between smokeless tobacco use, oral HPV infection and oral cancer.

Objective: The goal of this project is to examine the prevalence of oral HPV among women who are chronic tobacco users, and determine factors associated with HPV infection. The long-term objective is to inform oral cancer prevention strategies such as tobacco cessation and HPV vaccination within these communities.

Materials and Methods: In June and July 2019, 50 chronic smokeless tobacco users and 50 non-users from rural areas of Mysore were consented to participate in this study. Interviewer administered questionnaires were used to assess demographic and socioeconomic characteristics, tobacco and alcohol use history, and oral health behaviors. Oral samples were collected using an all-collection swab to collect oral cells of the center of tongue, below the tongue, hard palate, buccal mucosa, and upper front gums and placed into a sterile Qiagen collection tube. The brush in the collection kit was used on these regions and placed in the same collection tube as the swab. Lastly, 10 mL saline was given to participants to gargle before spitting out into a separate sample container. The samples were tested with the digeneHC2 High Risk HPV DNA test kit (Qiagen) using microplate chemiluminescence for the qualitative detection of 13 high-risk types of HPV DNA.

Results: The results show that the prevalence of high-risk oral HPV within these communities was very low (2%).

Conclusions: This study shows that the prevalence of oral-HPV among chronic smokeless tobacco using women of the rural/tribal community in Mysore, India, is similar to the prevalence of oral-HPV for women in the United States.