Oral Human Papillomavirus Prevalence and Genotyping Among Adults in the United Kingdom: The PROGRESS Study

Background In 2020, oropharyngeal cancer, which can be caused by human papillomavirus (HPV), accounted for 2,810 new cancer diagnoses and 1,004 deaths in the United Kingdom (UK). Despite a growing burden of HPV-associated cancers, little is known about the prevalence and genotype distribution of oral HPV infection in the UK. This study aimed to evaluate the prevalence of oral HPV and factors associated with high-risk (HR) and low-risk (LR) infection in the general UK population. Methods The PROGRESS (PRevalence of Oral HPV infection, a Global aSSessment) cross-sectional study was conducted in 17 UK dental practices. The study recruited adults aged 18 to 60 years undergoing routine examinations from November 2020 through July 2023. Participants completed behavioral questionnaires and provided oral rinse and gargle specimens; dentists reported on participants’ oral health status. SPF ₁₀ /DEIA/LiPA ₂₅ was used for HPV DNA detection and genotyping. Chi-square and Fisher’s exact tests were used to identify factors associated with HR and LR oral HPV. Results Overall, 53.8% of 1,096 participants were women; the mean age was 39.8 years. Prevalences of oral HPV were as follows: HPV of any genotype was 10.6%; HR HPV was 2.7%; 9-valent HPV vaccine type was 1.6%; and HPV-16 was 0.8%. Compared with women, men had a statistically significantly higher prevalence of any HPV (15.0% vs 6.8%) and HR HPV (4.5% vs 1.2%). The prevalence of any HPV was highest among men aged 51 to 60 years (23.3%), while the prevalence of HR HPV was highest among men aged 41 to 50 years (7.9%). HR HPV prevalence was also higher among those with periodontitis or gingivitis than those without these conditions (5.7% vs 1.3%; p < .0001). HR HPV prevalence increased with the lifetime number of female oral sex partners (≥ 26 compared with 1–5, 11.1% vs 4.7%; p =.0023). This trend was not observed for the lifetime number of male oral sex partners (≥ 26 compared with 1–5, 0.0% vs 0.9%; p =.0096). Conclusions In the UK, the prevalence of oral HPV, including HR genotypes, was higher among men older than 40 years than in other population groups, highlighting key groups for targeted prevention.