Efficacy of oral rinse and other detection methods in detecting oral human papillomavirus infections: The Oromouth cohort study.

Summary

In a 945-participant cohort undergoing tonsillectomy, oral rinse yielded the highest detection of oral HPV but still missed 73% of high-risk infections identified by other oral sites. Adding pharyngeal wall, tongue base, and tonsil sampling increased high-risk HPV detections by 38% over oral rinse alone, while serology added little.

Key Findings

• Combined multi-site sampling yielded HR-HPV prevalence of 4.3% and any HPV prevalence of 18%.
• Oral rinse alone had HR-HPV detection of 4.0% but missed 73% (11/15) of HR-HPV positives identified at other oral sites.
• Adding pharyngeal wall, tongue base, and tonsil sampling increased HR-HPV detections by 38% (11/29) over oral rinse alone; serology added minimal value.

Clinical Implications

Screening and surveillance protocols should consider multi-site sampling or validated adjunct methods rather than relying solely on oral rinse, to avoid underestimating high-risk HPV prevalence.

Limitations

• Population limited to patients undergoing tonsillectomy, potentially limiting generalizability
• Cross-sectional sampling without longitudinal persistence assessment
• Potential sampling variability across oral sites

Future Directions

Standardize multi-site sampling protocols, evaluate cost-effectiveness, and assess longitudinal persistence and transmission risk across sites to inform screening strategies.