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Dynamics and Determinants of HPV Infection: The Michigan HPV and Oropharyngeal Cancer (M-HOC) Study
  1. Marisa C Eisenberg1,
  2. Lora P Campredon1,
  3. Andrew F Brouwer1,
  4. Heather M Walline2,
  5. Brittany M Marinelli2,
  6. Yan Kwan Lau1,
  7. Trey B Thomas2,
  8. Rachel L Delinger1,
  9. Taylor S Sullivan1,
  10. Monica L Yost1,
  11. Christine M Goudsmit2,
  12. Thomas E Carey2,
  13. Rafael Meza1
  1. 1 Department of Epidemiology, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA
  2. 2 Department of Otolaryngology, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Marisa C Eisenberg; marisae{at} and Dr Rafael Meza; rmeza{at}


Introduction Human papillomavirus (HPV) is the primary cause of cervical and other anogenital cancers and is also associated with head and neck cancers. Incidence of HPV-related oropharyngeal squamous cell cancers (OPSCCs) is increasing, and HPV-related OPSCCs have surpassed cervical cancer as the most common HPV-related cancer in the USA. Given the multisite nature of HPV, there is strong interest in collecting data from both genital and oral sites, as well as associated data on social and sexual behaviours. The overarching goal of this study is to evaluate patterns of oral HPV infection incidence, clearance and persistence and their relationship to sexual behaviour history.

Methods and analysis Participants are recruited from two populations: college students at a large public university and general population from the surrounding area. At the first study visit, participants complete a detailed sexual history, health and behaviour questionnaire. Follow-up visits occur every 3–4 months over 3 years, when participants complete an abbreviated questionnaire. All participants provide a saliva sample at each visit, and eligible participants may provide a cervicovaginal self-swab. Genetic material isolated from specimens is tested for 15 high-risk and 3 low-risk HPV types. Statistical analyses will examine outcome variables including HPV prevalence, incidence, persistence and clearance. Logistic regression models will be used to estimate odds ratios and 95% confidence intervals for associations between the outcomes of interest and demographic/behavioural variables collected in the questionnaires. The longitudinal HPV infection data and detailed sexual history data collected in the questionnaires will allow us to develop individual-based network models of HPV transmission and will be used to parameterise multiscale models of HPV-related OPSC carcinogenesis.

Ethics and dissemination This study has been approved by the University of Michigan Institutional Review Board. All participants are consented in person by trained study staff. Study results will be disseminated through peer-reviewed publications.

  • human papillomavirus
  • oropharyngeal cancer
  • longitudinal study
  • sexual behavior
  • oral rinse

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  • Contributors The study was conceptualised and funding was obtained by MCE, TEC and RM. Methodology and original protocols were developed by MCE, LPC, AFB, HMW, BMM, YKL, TBT, RLD, CMG, TEC and RM. Project administration is managed by LPC and YKL. MCE, LPC, AFB, HMW, BMM, YKL, CMG, TEC and RM are responsible for the supervision of study implementation, staff and students. The original draft was prepared by MCE with the assistance of LPC, TSS and MLY. Review and editing were completed by MCE, LPC, AFB, HMW, BMM, YKL, TEC and RM.

  • Funding This work was supported by the National Institutes for Health Grant U01CA182915, the University of Michigan MCubed Program, a pilot grant from the University of Michigan Comprehensive Cancer Center’s Cancer Epidemiology & Prevention Program (supported by the National Cancer Institute of the National Institutes of Health grant P30CA046592), and the Michigan Institute for Clinical and Health Research (NIH Grant UL1TR000433).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The Michigan HPV and Oropharyngeal Cancer study was approved by the University of Michigan Institutional Review Board on 26 August 2014 (IRB # HUM00090326).

  • Provenance and peer review Not commissioned; externally peer reviewed.