Date of Graduation

Fall 8-11-2012

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Mary E. Von, DHEd, PA-C, DFAAPA

Second Advisor

Annjanette Sommers PA-C, MS

Abstract

Background: Oral malignancies currently constitute the sixth most common malignancy globally. Recent studies have shown strong correlation between Human Papillomavirus (HPV) and head and neck cancers, indicating that approximately 50% of oropharangeal cancers in the western world can be attributed to HPV. Furthermore, the relationship between high risk HPV and head and neck squamous cell carcinoma (HNSCC) is strengthened by an approximately 14 fold increase in risk for individuals who are infected with HPV 16.4 Yet the implementation of a well-studied, effective clinical screening tool in the detection of oral HPV has not been established. The purpose of this systematic review is to investigate different screening methods for detection and typing of oral HPV and to establish the need for a large randomized control study to create new guidelines by which HPV screening can be initiated.

Methods: An exhaustive literature search was performed using MEDLINE, CINAHL, and Web of Science databases using the following search terms “human papillomavirus” or “human papillomaviruses,” combined with “oral mucosa” or “oral malignancies” limited to publications in English performed on humans. Excluded were studies that focused on HIV positive or immunocompromised patients, studies that focused on DNA processing, systematic reviews. There were no exclusions made by GRADE criteria.

Results: The two studies presented in this systematic review have showed that mouth rinse and superficial scrapings are more effective than biopsies in the harvesting of oral DNA and in the detection of HPV in the oral cavity.

Conclusion: Repeated, definitive, single protocol studies have yet to determine which technique is most accurate for the harvesting of oral DNA in the detection of HPV, but all studies presented in this systematic review showed that mouth rinse and superficial oral scrapings were more effective than biopsies.

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