With the exceptions of oral cancer and liver cancer, recent data from Cancer Research UK show that cancer mortality rates are projected to fall across all cancers. In Scotland, oropharyngeal cancer is the fastest increasing cancer, particularly in men, with around 800 oral and pharyngeal cancer cases per year.
Although evidence suggests that this increase is being driven by Human Papilloma Virus (HPV) infection little is known about the rates, determinants and risk factors of oral HPV infection outside the US or in relation to HPV vaccination.
To address these knowledge gaps, a large scale epidemiological study to establish oral HPV prevalence and incidence in the Scottish population, whilst exploring risk factors and natural history of the infection will be taken forward by the Scottish Oral Health Strategy Public Health and Health Services Committee.
Professor Jan Clarkson and Dr Linda Young are co-applicants on a 20 month feasibility study, funded by the Chief Scientist Office in Scotland (CZH/4/917: June 2013-Jan 2015). The study is being led by the University of Glasgow and collaborators include the Universities of Dundee, Strathclyde, Edinburgh, MRC University of Edinburgh Centre for Reproductive Medicine, NHS Scotland, Greater Glasgow Health Board, NHS Lothian and Health Protection Scotland.
Aim and Objectives
The aim is to test the feasibility of undertaking a full population investigation into the prevalence, incidence, and persistence of oral HPV in Scotland via dental settings.
The objectives are to examine:
- The suitability of different dental settings, including assessment of different models of recruitment and follow-up
- Subject participation and consent rates
- Completion of data and sample collection / handling - including lifestyle / sexual history questionnaire, and oral gargle/rinse
- Feasibility of record linkage to national health datasets
- Sample validation for HPV detection assay
Setting Population and Target Recruitment
In Tayside, Kings Cross Hospital Dental Department and two general dental practices are participating. Participating centres in Greater Glasgow and Clyde are Glasgow Dental Hospital and two general dental practices.
Potential participants are male and female dental patients aged 16 to 69 years. Target recruitment is 500 participants who are willing to complete a lifestyle/sexual history questionnaire and provide an oral rinse.
Planned dissemination includes publication of results in peer review journals – including high impact, open-access, and specialist journals and presentations at national and international academic and clinical conferences and workshops across our multidisciplinary networks - including 'Wellbeing in Sexual Health' (WISH) network, the National Sexual Health & Blood Borne Viruses Ministerial Advisory Committee and the Scottish Sexual Health Epidemiology. A brief, accessible, lay summary of the research will be developed in the style of a newsletter and distributed to all participants as well as each recruitment site.