Sir, I read with interest the letter by S. S. Shetty and P. Shetty presenting a case of oral squamous cell carcinoma (OSCC) linked with early coitus and dormant human papilloma virus (HPV) in a 22-year-old mother.1 I would like to mention certain additions to this letter regarding the role of early coitus and dormant HPV in OSCC. In a study conducted by Schwartz et al. about oral cancer risk in relation to sexual history and evidence of HPV infection, it was found that HPV type 16 infection may contribute to the development of OSCC and factors such as early coitus, multiple sexual partners and history of genital warts were associated with oral cancer risk in men.2 There is a lack of convincing information about studies of OSCC linked with early coitus and dormant HPV in women in the literature. It seems reasonable to postulate that high-risk HPVs have evolved to maintain their infected host cell in a stem cell-like state in order to establish a persistent infection as pericoronitis or tonsillitis which later transforms into OSCC.3 An exfoliated oral cytology test for high-risk HPV is also feasible in this case.4
References
Shetty S S, Shetty P . Oral cancer: Link with early coitus. Br Dent J 2016; 220: 279–280.
Schwartz S M, Daling J R, Doody D R et al. Oral cancer risk in relation to sexual history and evidence of human papillomavirus infection. J Natl Cancer Inst 1998; 90: 1626–1636.
Münger K, Baldwin A, Edwards K M et al. Mechanisms of human papillomavirus-induced oncogenesis. J Virol 2004; 78: 11451–11460.
Smith E M, Ritchie J M, Summersgill K F et al. Age, sexual behavior and human papillomavirus infection in oral cavity and oropharyngeal cancers. Int J Cancer 2004; 108: 766–772.
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Shamim, T. Oral cancer: A reasonable postulation. Br Dent J 220, 430–431 (2016). https://doi.org/10.1038/sj.bdj.2016.316
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DOI: https://doi.org/10.1038/sj.bdj.2016.316