Human papillomavirus and oropharyngeal cancer among indigenous Australians: Protocol for a prevalence study of oral-related human papillomavirus and cost-effectiveness of prevention

Thumbnail Image
File version

Version of Record (VoR)

Jamieson, Lisa
Garvey, Gail
Hedges, Joanne
Mitchell, Amanda
Dunbar, Terry
Leane, Cathy
Hill, Isaac
Warren, Kate
Brown, Alex
Ju, Xiangqun
Roder, David
Logan, Richard
Johnson, Newell
Smith, Megan
Antonsson, Annika
Canfell, Karen
Griffith University Author(s)
Primary Supervisor
Other Supervisors
File type(s)

Background: Oropharyngeal cancer is an important, understudied cancer affecting Aboriginal and Torres Strait Islander Australians. The human papillomavirus (HPV) is a significant risk factor for oropharyngeal cancer. Current generation HPV vaccines are effective against the 2 most common types of high-risk HPVs in cancer (hrHPVs 16/18).

Objectives: This study aims (1) to yield population estimates of oncogenic genotypes of HPV in the mouth and oropharynx of defined Aboriginal and Torres Strait Islander populations; (2) to estimate the proportion of oropharyngeal cancer attributable to HPV among these Australian citizens; (3) to estimate the impact of HPV vaccination as currently implemented on rates of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians; and (4) taking into account impact on oropharyngeal as well as cervical cancer, to evaluate efficacy and cost-effectiveness of targeted extended HPV vaccination to older ages, among our study population.

Methods: Our study design and operation is straightforward, with minimal impost on participants. It involves testing for carriage of hrHPV in the mouth and oropharynx among 1000 Aboriginal South Australians by simple saliva collection and with follow-up at 12 and 24 months, collection of sexual history at baseline, collection of information for estimating health state (quality-of-life) utilities at baseline, genotyping of viruses, predictive outcome and cost-effectiveness modeling, data interpretation and development of vaccination, and follow-up management strategies driven by the Aboriginal community.

Results: Participant recruitment for this study commenced in February 2018 and enrollment is ongoing. The first results are expected to be submitted for publication in 2019.

Conclusions: The project will have a number of important outcomes. Synthesis of evidence will enable generation of estimates of the burden of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians and indicate the likely effectiveness and cost-effectiveness of prevention. This will be important for health services planning, and for Aboriginal health worker and patient education. The results will also point to important areas where research efforts should be focused to improve outcomes in Aboriginal and Torres Strait Islander Australians with oropharyngeal cancer. There will be a strong focus on community engagement and accounting for the preferences of individuals and the community in control of HPV-related cancers. The project has international relevance in that it will be the first to systematically evaluate prevention of both cervical and oropharyngeal cancer in a high-risk Indigenous population taking into account all population, testing, and surveillance options.

Journal Title

JMIR Research Protocols

Conference Title
Book Title




Thesis Type
Degree Program
Publisher link
Patent number
Grant identifier(s)
Rights Statement
Rights Statement

©Lisa Jamieson, Gail Garvey, Joanne Hedges, Amanda Mitchell, Terry Dunbar, Cathy Leane, Isaac Hill, Kate Warren, Alex Brown, Xiangqun Ju, David Roder, Richard Logan, Newell Johnson, Megan Smith, Annika Antonsson, Karen Canfell. Originally published in JMIR Research Protocols (, 08.06.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.

Item Access Status
Access the data
Related item(s)

Clinical sciences

Oncology and carcinogenesis not elsewhere classified

Health services and systems

Public health

Persistent link to this record