Background The incidence of HPV-associated oropharyngeal cancer is increasing substantially, especially among men. Our goal was to assess quantitative HPV16 and HPV18 detection in oral rinses obtained in dental offices in Seattle, Washington.

Methods We evaluated 15,313 oral rinses collected for during routine dental visits from 11/2016 to 11/2018. Multiplex Taqman qPCR was utilized to determine HPV16 and HPV18 viral load (VL).

Results In persons with a single sample, oral HPV was detected in 152(1%) persons: 127(0.83%) were HPV16 positive and 25(0.16%) were HPV18 positive. HPV16 was detected in 1.4% of men; the median age was 55 and median VL was 39.7 (range 0.1 - 589855.2 copies/mL). Only 0.4% of samples were HPV16 positive in women (median age 48, median VL 1.08, range 0.01 - 825 copies/mL). HPV18 was detected in 13(0.18%) men and 12(0.14%) women. A second oral rinse was collected in 628 persons (mean 6 months apart): 581 were HPV negative at baseline and only one became HPV16 positive at second rinse, 39 were HPV16 positive at baseline and 13 remained HPV16 positive at the second rinse, and 8 were HPV18 positive at baseline and 2 remained HPV18 positive at subsequent rinse. Patients with consecutive positive tests were all men and had higher baseline median VL (385 vs 0.90 HPV16 copies/mL; 24 vs 0.80 HPV18 copies/mL) compared to those with first positive and second negative samples.

Conclusion Oral rinse is an acceptable method of HPV testing and patients seen for routine dental care are interested in testing. Comparable to published studies, oral HPV was more frequent among men than women, especially at higher VL levels. HPV16 persistence was more common in those with high VL at baseline test. Future studies are needed to evaluate the feasibility of an effective primary and secondary screening strategy for oropharyngeal cancer using quantitative oral HPV detection.

Disclosure No significant relationships.