A series of saliva HPV tests being conducted by Queensland University of Technology (QUT), in Brisbane, Australia, detected an asymptomatic throat cancer (Front Oncol 2020;10:408. doi: 10.3389/fonc.2020.00408).
The tests were taken as part of an ongoing HPV-16 DNA prevalence study, according to the case report. The study included 665 healthy people who provided saliva samples that were tested using the QIAamp DNA Mini Kit (Qiagen), which is a quantitative polymerase chain reaction assay.
“To take the test, all the person has to do is give a salivary oral rinse sample. When the test shows HPV-16 DNA, it is repeated, and if the presence of HPV-16 is persistent over a period of time, we would be suspicious that there may be underlying cancer,” said Chamindie Punyadeera, PhD, MPhil, an associate professor at QUT, who co-developed the test.
The patient’s positive tests raised the alert, according to Dr. Punyadeera. “The person whom we reported in this study had been consistently HPV-16 DNA–positive for 36 months, with a steadily rising count of HPV-16 DNA after testing at six, 12 and 36 months.
The patient was a heterosexual man; his sexual history includes multiple oral partners, followed by a long-term monogamous relationship. He was an ex-smoker and a social drinker.
“Since the surgery, the patient has had no evidence of HPV-16 DNA in his saliva,” She said.
The researchers believe this is the first report of a noninvasive test detecting HPV-DNA in a saliva sample from an infected healthy person, but wide validation is required to confirm the finding. “The presence of this pattern of elevated salivary HPV DNA must be fully evaluated, as it may provide the critical marker for early cancer detection,” Dr. Punyadeera said. “We now have the promise of a screening test for oropharynx cancer, and there is an urgent need to undertake a major study to validate this test and the appropriate assessment pathway for people with persisting salivary HPV DNA.”
Persistent HPV infection is now the leading cause of cancers in the oropharynx. “The incidence of high-risk human papillomavirus-driven throat cancers is on the rise in developed countries and, unfortunately, it is often discovered only when it is more advanced, with patients needing complicated and highly impactful treatment,” Dr. Punyadeera said. “In the U.S., HPV-driven throat cancers have surpassed cervical cancers as the most common cancer caused by HPV, but unlike cervical cancer, up until now, there has been no screening test for this type of oropharyngeal cancer.”
—Clinical Oncology News Staff
The prevalence study was funded by Janssen Biotech Inc.