在美国，口咽癌是由高危型（HR）人乳头瘤病毒（HPV）感染引起的最常见的与HPV相关的癌症，超过了宫颈癌。然而，对于一般人群口腔HPV感染的普遍性和基因型分布知之甚少。为了评估美国一般人群口腔HPV感染的普遍性和与高危型和低危型感染相关的因素，我们进行了名为PROGRESS（全球口腔HPV感染的普遍性评估）的横断面观察性研究。该研究在美国的43个牙科诊所（24个城市、13个城市聚集地、6个农村地区）进行，横跨21个州，于2021年11月至2022年3月进行。符合条件的参与者年龄在18至60岁之间，前往牙科诊所进行常规牙科检查。牙科诊所使用定向抽样方法招募男性和女性以及各年龄组的参与者，确保男女比例和年龄组分布均匀。参与者提供口腔漱口样本进行HPV DNA和基因型检测，并填写行为问卷，牙医报告口腔健康状况。HPV DNA和基因型检测在中央实验室中使用SPF10/DEIA/LiPA25系统进行。口腔HPV感染普遍性。共有3196名参与者纳入研究，平均年龄为39.6（12.1）岁，其中55.5%为女性。任何HPV基因型的口腔HPV感染普遍性为6.6%（95% CI，5.7%-7.4%），高危型HPV感染、HPV-16感染和9价HPV疫苗型感染的普遍性分别为2.0%（95% CI，1.5%-2.5%）、0.7%（95% CI，0.4%-1.0%）和1.5%（95% CI，1.1%-1.9%）。在HPV阳性的参与者中，HPV-16是最常见的基因型（男性中占12.4%，女性中占8.6%）。男性的HPV感染率高于女性，男性51至60岁年龄组的感染率最高（任何HPV、高危型HPV和HPV-16的感染率分别为16.8%、6.8%和2.1%）。与高危型口腔感染相关的因素包括男性（调整后的奥斯比比值[AOR]，3.1；95% CI，1.2-8.5）、年龄为51-60岁（AOR，3.3；95% CI，1.5-7.3）、有26个或更多个生涯男性性伙伴（AOR，6.5；95% CI，2.3-18.7）和有6-25个生涯女性口交伴侣（AOR，3.4；95% CI，1.3-8.7）。在这项横断面研究中，口腔HPV负担在年长男性中最高，这些人可能更容易患上口咽癌。除了男性和年龄较大外，高危型口腔HPV感染还与性行为有关，包括男性性伙伴数量增加和女性口交伴侣数量增加。

In the US, oropharyngeal cancer, predominantly caused by high-risk (HR) human papillomavirus (HPV) infection, is the most frequent HPV-associated cancer, surpassing cervical cancer. However, little is known about oral HPV prevalence and genotype distribution in the general population.To assess oral HPV prevalence and factors associated with HR and low-risk infection in a general US population.PROGRESS (Prevalence of Oral HPV Infection, a Global Assessment) was a cross-sectional observational study conducted between November 2021 and March 2022 in 43 dental offices in the US (24 urban, 13 urban cluster, and 6 rural sites), spanning 21 states. Eligible participants were aged 18 to 60 years, visiting dental clinics for routine dental examination. Dental clinics used targeted sampling to recruit equal distributions of men and women and across age groups.Participants provided an oral gargle specimen for HPV DNA and genotyping and completed behavioral questionnaires, and dentists reported oral health status. Detection of HPV DNA and genotyping was performed using the SPF10/DEIA/LiPA25 system at a central laboratory.Oral HPV prevalence.Of the 3196 participants enrolled, mean (SD) age was 39.6 (12.1) years, and 55.5% were women. Oral HPV prevalence was 6.6% (95% CI, 5.7%-7.4%) for any HPV genotype, and 2.0% (95% CI, 1.5%-2.5%), 0.7% (95% CI, 0.4%-1.0%), and 1.5% (95% CI, 1.1%-1.9%) for HR, HPV-16, and 9-valent-HPV vaccine types, respectively. Among HPV-positive participants, HPV-16 was the most prevalent genotype (12.4% among men and 8.6% among women). Prevalence of HPV was higher in men than women and highest among men aged 51 to 60 years (16.8%, 6.8%, and 2.1% for any HPV, HR HPV, and HPV-16, respectively). Factors associated with HR oral infection included being male (adjusted odds ratio [AOR], 3.1; 95% CI, 1.2-8.5), being aged 51 to 60 years (AOR, 3.3; 95% CI, 1.5-7.3), having 26 or more lifetime male sex partners (AOR, 6.5; 95% CI, 2.3-18.7), and having 6 to 25 lifetime female oral sex partners (AOR, 3.4; 95% CI, 1.3-8.7).In this cross-sectional study, oral HPV burden was highest among older men who may be at higher risk of developing oropharyngeal cancer. In addition to male sex and older age, HR oral HPV infection was also associated with sexual behaviors, including increasing number of male sex partners and female oral sex partners.