Epidemiology of Oral Human Papillomavirus Infection among Diverse Chinese Adults in Typical Areas of China: Findings from the DLCC Study

BACKGROUND: Human papillomavirus (HPV) infection is a predominant cause of oropharyngeal squamous cell carcinoma. However, there is limited knowledge about the epidemiology of oral HPV infections among adults in China. METHODS: We collected data from a prospective cohort that enrolled participants in Mainland China. A total of 9,867 participants ages at least 20 years provided oral swab specimens in typical areas of China (Hebei and Guangdong provinces) in 2021. HPV DNA in oral exfoliated cells was tested using nested PCR and sequencing. Prevalence among subpopulations was compared. Multivariable logistic regression models were employed to assess possible factors influencing oral HPV infection. RESULTS: The overall prevalence of oral HPV infection was 3.0% [95% confidence interval (CI): 2.68–3.36]. Among those infected, 1.3% (1.08–1.53) were infected with high-risk HPV types. Men had a higher age-standardized HPV infection prevalence (3.6%, 2.96–4.29) compared with their female counterparts (2.7%, 2.35–3.12). People in Hebei had a higher age- and sex-standardized prevalence (4.1%, 3.50–4.70) than those in Guangdong (2.2%, 1.80–2.56). Generally, men (OR and 95% CI: 1.42, 1.09–1.85) and people in Hebei (2.01, 1.53–2.65) had higher odds of any type of HPV infection. In addition, people living in urban areas had a 2.15-fold (1.43–3.26) higher odds of high-risk HPV infection. CONCLUSIONS: This study reveals a low prevalence of oral HPV infection with significant geographic and sex differences among Chinese population. IMPACT: This is the first study to report the epidemiologic characteristics of oral HPV infection among Chinese adults in diverse geographic areas with large sample size.