The results of the HOTSPOT study, presented at the 2013 American Society of Clinical Oncology (ASCO) Annual Meeting, showed that the rate of positive detection of oral HPV infection in spouses is not increased compared to the general population and that couples who have been together for many years do not need to change their intimacy and sexual behavior because of a diagnosis of oropharyngeal cancer. Many spouses of patients with human papilloma virus (HPV)-positive oropharyngeal cancer (OPC) are concerned about their risk of developing HPV-related tumors. The History of Oral Human Papillomavirus Transmission in Partners over Time (HOTSPOT) study, the first large-scale test of HPV infection in the oral cavity of patients with HPV-induced oropharyngeal cancer and their spouses, found that, compared with the general population, spouses The study found no increase in the rate of positive detection of oral HPV infection in spouses compared to the general population. HPV infection is common in both men and women in the United States, but the vast majority of individuals infected with HPV do not develop tumors. Over the past 20 years, however, the incidence of HPV-positive head and neck cancer has increased significantly, particularly among non-Spanish-speaking white men in the United States. HPV-positive oropharyngeal cancer patients and their spouses are often concerned about HPV transmission through the mouth and want to know their spouse’s risk of developing the tumor, noted D’Souza, PhD, MPH, MS-Gypsyamber, an associate professor of epidemiology at Johns Hopkins University in Baltimore, Maryland, who led the study’s sponsor. The results of this study confirm that oropharyngeal cancer partners do not have an increased rate of oral HPV infection and that their risk of HPV-associated oropharyngeal cancer remains low. Couples who have been together for many years may already share each other’s infections and do not need to change the way they are physically intimate. This study enrolled 147 HPV-OPC patients and 83 spouses/partners. the OPC patients were predominantly male and the partners were predominantly female. The median age of the OPC patients in the study was 56 years. Samples for detection of HPV DNA in the oral cavity were collected from 30-second oral cleansers and mouthwashes at the time of disease diagnosis and 1 year later. The oral rinse samples were tested for 36 different HPV subtypes including HPV16, which is responsible for most HPV-OPC and a variety of other tumors. HPV DNA was detectable in 66% of oral rinse samples from patients with HPV-OPC, and only 7% of patients still had oral HPV infection after one year of oncology treatment. The overall HPV prevalence in the oral cavity of the patients’ partners was 7.2%. 75 female partners had an oral HPV prevalence of 5%, which is comparable to the HPV prevalence in the oral cavity of women in the general population (value of 4%, data from previous reports). The prevalence of HPV infection in the oral cavity of a few male partners, although higher than in the female population, was similar to the prevalence of infection in the oral cavity of men in the general population. HPV16, the culprit of most HPV-OPC, was detected in 54% of samples from HPV-OPC patients, 2.7% in the oral cavity of female partners, and not in male partners. Overall, the researchers claim that the findings provide reassurance to women and male partners that they are at low risk of HPV-OPC. No precancerous lesions or tumors were found in 64% of the partners who underwent visual oral examinations. Dr. Gregory Masters, ASCO spokesperson and head and neck oncologist, noted that HPV is responsible for thousands of cases of oropharyngeal cancer, cervical cancer and other site tumors that occur each year. This study raises awareness of the risk of HPV infection in the partners of HPV-positive oropharyngeal cancer patients. He is certain that this news provides long-awaited reassurance for patients and their spouses and partners. However, the investigators emphasize that more young couples need to be surveyed to better understand HPV oral transmission.