ArticleCancer2021
Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer.
Article in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- [The role of serological (rapid) tests for the early detection of HPV-related cancers].Dermatologie (Heidelberg, Germany) · 2026Pooled it
- 2023 Korean sexually transmitted infections guidelines by the Korean Association of Urogenital Tract Infection and Inflammation: Human papillomavirus vaccination.Investigative and clinical urology · 2024Guideline
- Behavioral Risk Factors and Seroprevalence for Human Papillomavirus in Sinonasal Carcinoma: A Multi-Institutional Case-Control Study.Head & neck · 2026Article
- Stress Disorders and Human Papillomavirus-Related Cancer Rates: A Population-Based Cohort Study in Denmark.Clinical epidemiology · 2026Article
- Sociodemographic disparities among Floridians diagnosed with oropharyngeal cancer.BMC public health · 2025Article
- Epidemiological Trends in the Characterization of Human Papillomavirus Virus-Related Oropharyngeal Cancer: A Global Perspective.Current oncology reports · 2025Review
- Patient experience and shared decision-making in HPV-positive oropharyngeal cancer: A systematic review of qualitative and quantitative evidence.Clinical and translational radiation oncology · 2025Review
- Review
- The influence of tobacco use, hazardous drinking, and other risk factors on HPV-associated oropharyngeal cancer risk and screening perceptions among gay and bisexual men: a cross-sectional study.BMC oral health · 2025Article
- HPV and Cervical Cancer-Biology, Prevention, and Treatment Updates.Current oncology (Toronto, Ont.) · 2025Review
- Oral human papillomavirus (HPV) prevalence and genotyping among healthy adult populations in the United States and Europe: results from the PROGRESS (PRevalence of Oral hpv infection, a Global aSSessment) study.EClinicalMedicine · 2025Article
- HPV-associated oropharyngeal cancer: in search of surrogate biomarkers for early lesions.Oncogene · 2024Review
- Addressing sexual health in oncology: perspectives and challenges for better care at a national level.Ecancermedicalscience · 2024Article
- Epidemiology of Oral Human Papillomavirus Infection among Diverse Chinese Adults in Typical Areas of China: Findings from the DLCC Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Etiology, diagnosis, treatment, and prevention of human papilloma virus-associated oropharyngeal squamous cell carcinoma.International journal of clinical oncology · 2023Review
- Article
- Article
- Transmission and clearance of human papillomavirus infection in the oral cavity and its role in oropharyngeal carcinoma - A review.Reviews in medical virology · 2023Review
- Oral/oropharyngeal "selfies" in gay and bisexual men: a pilot study exploring oropharyngeal screening for HPV-related possible malignancies.Frontiers in public health · 2023Article
- Feasibility of clinical evaluation of individuals with increased risk for HPV-associated oropharynx cancer.Head & neck · 2023Article
Corrections and comments
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Authors and funding
19 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundCase-control studies from the early 2000s demonstrated that human papillomavirus-related oropharyngeal cancer (HPV-OPC) is a distinct entity associated with number of oral sex partners. Using contemporary data, we investigated novel risk factors (sexual debut behaviors, exposure intensity, and relationship dynamics) and serological markers on odds of HPV-OPC.
methodsHPV-OPC patients and frequency-matched controls were enrolled in a multicenter study from 2013 to 2018. Participants completed a behavioral survey. Characteristics were compared using a chi-square test for categorical variables and a t test for continuous variables. Adjusted odds ratios (aOR) were calculated using logistic regression.
resultsA total of 163 HPV-OPC patients and 345 controls were included. Lifetime number of oral sex partners was associated with significantly increased odds of HPV-OPC (>10 partners: odds ratio [OR], 4.3 [95% CI, 2.8-6.7]). After adjustment for number of oral sex partners and smoking, younger age at first oral sex (<18 vs >20 years: aOR, 1.8 [95% CI, 1.1-3.2]) and oral sex intensity (>5 sex-years: aOR, 2.8 [95% CI, 1.1-7.5]) remained associated with significantly increased odds of HPV-OPC. Type of sexual partner such as older partners when a case was younger (OR, 1.7 [95% CI, 1.1-2.6]) or having a partner who had extramarital sex (OR, 1.6 [95% CI, 1.1-2.4]) was associated with HPV-OPC. Seropositivity for antibodies to HPV16 E6 (OR, 286 [95% CI, 122-670]) and any HPV16 E protein (E1, E2, E6, E7; OR, 163 [95% CI, 70-378]) was associated with increased odds of HPV-OPC.
conclusionNumber of oral sex partners remains a strong risk factor for HPV-OPC; however, timing and intensity of oral sex are novel independent risk factors. These behaviors suggest additional nuances of how and why some individuals develop HPV-OPC.
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Registered trials
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