Alemany, LaiaFelsher, MarisaGiuliano, Anna R.Waterboer, TimMirghani, HaïthamMehanna, HishamRoberts, CraigChen, Ya-TingLara, NúriaLynam, MarkTorres, MayaraPedrós, MontseSánchez, EmilioSpitzer, JacqueSirak, BradleyQuirós, BeatrizCarretero, GemaPaytubi Casabona, SòniaMorais, EdithPavón, Miquel Ángel2025-02-182025-02-182025-01-012589-5370https://hdl.handle.net/2445/218895Background HPV-related oropharyngeal squamous cell carcinoma (OPSCC) is increasing in incidence, yet there are few well-designed oral HPV epidemiology studies in general populations. This study assessed oral HPV prevalence and risk-factors among a general population in Europe and the United States (US). Methods The cross-sectional study was conducted between November 2020 and July 2023 in 105 dental offices in France, Germany, Spain, the United Kingdom (UK) and US. Participants were aged 18-60 and visiting dental clinics for routine examination. Participants provided oral gargle specimen for HPV DNA and genotyping and completed behavioral questionnaires. HPV DNA detection and genotyping was performed using SPF10/DEIA/ LiPA25 at central laboratories. Findings Of 7674 participants, mean (SD) age was 40.0 (11.9), and 45.8% were males. Among men, any oral HPV prevalence ranged between countries from 6.6% to 15.0% and 1.8%-4.5% for high-risk (HR) types. Among women, any oral HPV prevalence ranged between countries from 3.6% to 6.8% and 0.2%-2.1% for HR types. HR infection among men was associated with older age (AOR 1.04; 95% CI: 1.02, 1.06); marijuana use (AOR 1.92; 95% CI: 1.19-3.11); increasing number of lifetime female oral sex partners; and by country, residing in the UK compared to Spain (AOR 2.89; 95% CI: 1.30-6.43). HR infection among women was associated with lifetime marijuana use (AOR 2.33; 95% CI: 1.18-4.60) and by country, residing in France compared to Spain (AOR 4.46; 95% CI: 1.26-15.77). Interpretation Oral HPV burden was highest among older men who may be at risk of developing OPSCC. Funding Funding for this research was provided by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. Copyright (c) 2025 Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. and The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/). 2025;79: Published https://doi.org/10. 1016/j.eclinm.2024. 103018application/pdfengcc by-nc-nd (c) Alemany, Laia, 2025http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/article2025-02-07info:eu-repo/semantics/openAccess39896062