HPV spreading by word of mouth, increasing rate of oropharynx cancers

February 2, 2012 | by

The human papillomavirus, or HPV, has gotten a lot of attention because of its association with cervical cancer — but it also can infect the throat and mouth and cause oral cancers. Recent research suggests it causes more of these oral cancers than experts previously thought.

Image of human papillomavirus cells

Human papillomavirus cells

A study in the Journal of the American Medical Association showed that about 7 percent of men and women between ages 14 and 69 had HPV in the mouth, and oral infection is nearly three times as common in men as in women. (About one in every 10 men in the study had it).

Over the past decade, cases of mouth and throat cancers related to HPV have grown by more than 4 percent ever year, and the majority are in the throat (base of tongue and tonsils) — something that might be linked to changes in sexual practices like oral sex, according to the American Cancer Society. Whatever the cause, specialists like City of Hope’s Joel Epstein, D.M.D., M.S.D., director of the Division of Oral Medicine, are seeing the result in their clinics.

Says Epstein:

HPV-related cancers of the mouth and throat — primarily the oropharynx — are on the rise while the overall incidence rate of cancers is declining. Smoking is the other major factor that contributes to mouth and orophayrnx cancers, but those HPV-unrelated cases have been on a steady decline.

Over 90 percent of HPV-related oropharyx cancers are due to the HPV 16 strain of the virus, which is also a major virus strain in cervical cancers. The two HPV vaccines currently approved for girls and young women inoculate against HPV 16, among other strains.

Last October, an advisory committee for the Centers for Disease Control and Prevention recommended HPV vaccination for young boys, similar to the recommendations they had provided for young girls earlier. [The American Academy of Pediatrics issued a similar recommendation this week.]

From an epidemiological perspective, it makes sense to vaccinate the population during their childhood, but there are cost issues that need to be considered as well. We don’t know if HPV infection is an epidemic in the starting stages or if HPV-related cancers will remain relatively rare in comparison to other cancers.

HPV-related oropharynx cancers started rising in 1985, he notes, and HPV has a long incubation period before leading to cervical, anal or head and neck cancers. Only a portion of infected people who do not clear the virus may be at risk for cancers. That sounds very similar, he says, to another sexually transmitted virus that the general public is familiar with: human immunodeficiency virus, or HIV.

About 40,250 Americans will be diagnosed this year with some form of cancer in the mouth or throat, according to the American Cancer Society. The death rate is continuing to drop, with about 7,850 deaths attributed to the disease.

  • jeffrey

    how can a person test for tongue cancer?

    • http://www.cityofhope.org City of Hope

      Hi Jeffrey, look for any unusual changes in your mouth and tongue, and also make sure your dentist looks and feels around thoroughly as part of their regular exams. Here are some good guidelines as to what to look for: http://tinyurl.com/6wlw87z.

  • Terry

    Hi, my husband of 22yrs is recoving from HPV related back of throat cancer. They told him it was stage IV. He has had two PET scans since treatment and both have been clear. Our concern is now, how do we know if we are passing the virus back and forth. I have had paps/w screening for HPV (negitive) this year. He is afraid he will give his virus to me. He has asked his doctors but no one can give him a clear answer. I hope you can shed some light. Thanks

    • http://www.cityofhope.org City of Hope

      Hi Terry, evidence shows that HPV is spread sexually or at birth, and scientists think it may be able to be spread by mouth, but the data is unclear on that so far. Like any virus, exposure to HPV doesn’t necessarily lead to infection and it isn’t necessarily cancer-causing. It’s complicated because it appears that most people can clear the virus after they’re exposed to it. But it isn’t known yet whether people with HPV-related cancers are generally free of their virus after treatment. Much research still needs to be done. Until there are more definitive findings, we recommend you follow the advice of your personal physicians.

  • Mark

    Is a white collection on the base of the tongue and occasional blood stain from the throat, throat hoarseness the beginning stages of HPV related cancer ? How do we recognize HPV related throat or tongue infection ?

    • RobinDTaxpayer