Abstract A134: Prevalence of non-vaccine targeted oncogenic oral and genital HPV types among U.S. adults

Abstract

More than 200 human papillomavirus (HPV) types have been identified, but only 12 are carcinogenic. The 9-valent HPV vaccine targets seven carcinogenic types (HPV16, 18, 31, 33, 45, 52, and 58), including HPV16/18, which account for most HPV-associated cancers. However, HPV35, 39, 51, 56, and 59 are not covered by current vaccines and are less well characterized. Data on these non-vaccine-targeted (NVT) types among U.S. adults are limited. We conducted a cross-sectional analysis of adults aged ≥18 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 of oral, vaginal, and penile HPV. We estimated survey-weighted type-specific HPV prevalence by race/ethnicity and used Poisson regression to calculate adjusted prevalence ratios (aPRs), adjusting for age, sex, race/ethnicity, lifetime cigarette smoking, number of lifetime sexual partners, and HPV vaccination status. Oral HPV prevalence was low overall, with HPV16 the most frequently detected type (0.89%), followed by HPV59 (0.53%), HPV51 (0.39%), HPV35 (0.20%), HPV56 (0.19%), HPV39 (0.14%), and HPV18 (0.09%). Non-Hispanic White (NHW) participants had the highest prevalence of oral HPV16 (1.08%) and HPV51 (0.48%), while Non-Hispanic Black (NHB) participants had the highest prevalence of HPV18 (0.25%), HPV35 (0.64%), HPV56 (0.45%), and HPV59 (0.87%). Males had a higher prevalence of all oral types. Genital HPV prevalence was highest for HPV51 (4.21%), followed by HPV16 (3.41%), HPV59 (2.94%), HPV39 (2.61%), HPV35 (1.65%), and HPV18 and 56 (1.5% each). NHW participants had the highest prevalence of genital HPV16 (3.76%); NHB participants had the highest prevalence of HPV18 (2.69%), HPV35 (4.34%), HPV51 (5.45%), HPV56 (1.80%), and HPV59 (4.41%). Males had a higher prevalence of all genital types, except HPV56. Dual oral-genital infections were rare, occurring most frequently in HPV59 (0.24%), followed by HPV16 and 51 (0.14% each). Dual infections were most common in HPV16, 18, 35, and 59 for NHB participants, in HPV39 for other racial/ethnic groups, and in HPV51 for NHW participants. NHB participants (aPR 1.91, 95% CI 1.10-3.30) and vaccinated individuals (aPR 2.08, 95% CI 1.01-4.30) had a significantly higher prevalence of any NVT oncogenic HPV compared with NHW participants and unvaccinated individuals, respectively. Increasing lifetime number of sexual partners was independently associated with a higher prevalence of NVT oncogenic HPV, whereas associations with sex and lifetime cigarette smoking were not statistically significant. NVT oncogenic HPV genotypes were prevalent among U.S. adults, with type distribution and site varying by race/ethnicity. The association between HPV vaccination and NVT HPV warrants confirmation in longitudinal studies. Further investigation of their contribution to HPV-associated malignancies may inform the development of expanded vaccines targeting additional oncogenic HPV types. Morgan C. Byrd, Mary Ho, Qiyao Mak, Manoela Hirata. Prado, Alexandra E. Hunter, Vincent M. D'Anniballe, Eseosa Odigie, Brian B. Hughley, Nosayaba Osazuwa-Peters. Prevalence of non-vaccine targeted oncogenic oral and genital HPV types among U.S. adults [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr A134.