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Gum Disease May Lead to Head, Neck Cancers, Study Finds

Chronic gum disease may leave the mouth more susceptible to head and neck cancers caused by the human papillomavirus, a study found.

Of 124 patients diagnosed with the cancers in the study, 40 percent had tumors that tested positive for a strain of human papillomavirus, research published online today in the Archives of Otolaryngology -- Head & Neck Surgery found.

About 10 percent of men and 3.6 percent of women are orally infected with HPV, a virus usually transmitted through sexual activity that may lead to cancer, according to a January study in the Journal of the American Medical Association. Today’s findings show that dentists and doctors need to treat chronic gum disease to help reduce the likelihood the virus can infect the mouth, the authors said.

“We have become increasingly aware of the HPV virus causing this type of cancer and it shows why we need to be aggressive in terms of our dental care,” Dennis Kraus, director of Head and Neck Oncology at Lenox Hill Hospital in New York, said today in a telephone interview. Kraus wasn’t involved in the study.

Kraus said while it’s unclear why gum disease leaves people more open to HPV, bacteria in the mouth may make it more susceptible to the virus or it could be an immunological response.

Human papillomavirus is the most-common sexually transmitted virus in the U.S., where half the population will be infected at some time in their lives, according to the Centers for Disease Control and Prevention. It is known to cause cervical, vulvar, vaginal, penile and anal cancer.

Available Drugs

It’s unknown whether Merck & Co. (MRK)’s Gardasil and GlaxoSmithKline Plc (GSK)’s Cervarix vaccines, which target genital HPV, will protect against oral infections.

Gardasil is approved for preventing cervical, vaginal and anal cancers and genital warts, and is recommended for girls and women 9 to 26 years old. It’s also approved for genital warts and anal cancer in boys and men of the same ages. Cervarix is approved for preventing cervical cancer in females 9 to 25.

Researchers in the study looked at data from 124 patients diagnosed from 1999 to 2007 with cancers of the oral cavity, which include the lips, part of the tongue and mouth, oropharynx, which includes the back of the mouth, base of the tongue and the tonsils, and larynx, which includes the vocal cords.

They found that about 65 percent of the oropharyngeal cancers were HPV positive, compared with 29 percent of the oral cavity cancers and 21 percent of the laryngeal cancers.

Signs of Disease

Those who were HPV positive had higher rates of alveolar bone loss around the teeth, the researchers found. Each millimeter of bone loss was associated with a 2.6 times increased risk of a HPV-positive tumor.

“If you have gum disease, have treatment and keep up with good oral hygiene,” Mine Tezal, the lead study author and an assistant professor at the University at Buffalo, the State University of New York, said today in an e-mail. “Prevention or treatment of sources of inflammation in the oral cavity may be a simple yet effective way to reduce the acquisition and persistence of oral HPV infection.”

The study was supported by grants from the National Cancer Institute and the National Institute of Dental and Craniofacial Research.

To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net

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