February 01, 2016

Oral HPV Spit Test Now Offered at Fauquier ENT!

Image courtesy of stockimages at FreeDigitalPhotos.net
Given the increasing concern for HPV triggered oral and throat cancer, patients have been requesting a way to check for HPV in the mouth, especially in those who are sexually active. Beyond a visual inspection using a tongue blade and an endoscope, our office now offers a spit test to evaluate for the presence of HPV by looking for its DNA shed into the saliva.

The typical patient, man or woman, who may benefit from this test include:

• Spouses or significant others of patients who have known oral HPV (worried about "catching" it from their partner thru kissing or oral sex). More info on this.
• Monitor patients with known oral HPV for clearance after treatment
• Patients with traditional risk factors for oral cancer
• Patients with suspicious oral lesions

This oral HPV spit test focuses on those common HPV infections known to more frequently progress to cellular changes causing papillomas and even cancer. The test is based on a similar test that is FDA approved for samples from the anogenital tract.

There are two types of oral HPV testing that we offer:

HPV Complete Panel which checks for 51 different HPV strains: 2a, 6, 11, 16, 18, 26, 30, 31, 32, 33, 34, 35, 39, 40, 41, 42, 43, 44, 45, 49, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 64, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 80, 81, 82, 83, 84, and 89

HPV High Risk Panel which only checks for HPV known to potentially cause cancer: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68

Generally speaking, we only recommend the HPV High Risk Panel as most other strains of HPV can be naturally and automatically cleared by the body's immune system without treatment, risk, or symptoms.

The test is performed as follows in our office and takes about one minute to complete:

Step 1: Patient swishes and gargles a saline solution for 30 seconds
Step 2: Patient spits the solution into a funneled collection tube
Step 3: Funnel is removed and cap is secured to top of collection tube
Step 4: Sample is labeled with patient name and date of birth and mailed to a laboratory
Step 5: Results received in about one week

This test MAY be covered by insurance (CPT 87624). However, coverage depends on your specific plan and if not covered by your insurance, will be a self-pay cost.

Keep in mind that this test, if positive, still does not tell us WHERE the HPV infection is located... tonsil? tongue? pharynx? palate?

A good visual examination is still required... and if any suspicious lesions are found, surgical biopsy is THE definitive way to test for cancer and check for HPV.

Of note, there are currently 3 FDA approved HPV vaccines:

• The bivalent HPV vaccine (Cervarix) which addresses HPV 16 and 18;
• The quadrivalent HPV vaccine (Gardasil) which prevents four HPV types: HPV 16 and 18, as well as HPV 6 and 11;
• And finally Gardasil 9 which prevents 9 HPV types: 6, 11, 16, 18, 31, 33, 45, 52, and 58.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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