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HPV Linked to Throat Cancer

Oral Sex Is Major Risk Factor
WebMD Health News
Reviewed by Louise Chang, MD

May 9, 2007 - HPV, the virus that causes cervical cancer, is also linked to throat cancer, and oral sex is a major risk factor for both men and women, new research shows.

Having multiple oral sex partners topped the list of practices associated with an increased risk of developing oropharyngeal cancer, according to the study published in the May 10 issue of The New England Journal of Medicine.

People in the study who reported having a history of six or more oral sex partners were three times as likely to develop the cancer as people who reported that they had never had oral sex.

In looking at patients with tumors that were positive for a particular strain of HPV already well-linked to cervical cancer, six or more oral sex partners increased risk for throat cancer by eightfold.

And those who showed evidence of a prior oral infection with human papillomavirus (HPV) were 32 times more likely to develop the cancer.

Oral sex seemed to be the main mode of transmission for oral HPV, although the researchers note that transmission from mouth to mouth contact couldn't be excluded. The new study shows that oral HPV infection is linked to head and neck cancer regardless of two other known risk factors: heavy tobacco and alcohol use.

But longtime HPV researcher Maura L. Gillison, MD, PhD, of Johns Hopkins University in Baltimore, says the findings should not be seen as cause for undue alarm.

“This is a very uncommon cancer, so a person’s individual risk is pretty small,” she tells WebMD.

Sex, Smoking, and Alcohol

Gillison and colleagues first reported the link between oral HPV infection and head and neck cancer in 2000, and since then dozens of other studies have bolstered the finding.

But their latest investigation is among the first to comprehensively examine the behaviors that contribute to risk.

Longtime heavy tobacco and alcohol use are among the strongest identified risk factors for head and neck cancers.

But the new findings suggest that HPV is a stronger risk factor for oropharyngeal cancer, which Gillison says accounts for about one in four head and neck cancers. Oropharyngeal cancer occurs in the area beyond the mouth from the base of the tongue to the back of the throat.

“The number of oropharyngeal cancers caused by HPV is probably larger than the number caused by smoking and alcohol, at least in the U.S.,” Gillison says.

The new research included 86 men and 14 women with a new diagnosis of oropharyngeal cancer and 200 sex- and age-matched people without cancer.

Both groups completed anonymous surveys examining sexual history and other lifestyle factors, and oral swabs, blood, and saliva samples were collected from all participants.

HPV 16, one of two HPV strains that cause 70% of cervical cancers and 90% of head and neck cancers that are HPV-positive, was found in 72% of the oropharyngeal tumors. Evidence of prior HPV 16 exposure, in the form of antibodies to the virus, was also strongly linked to oropharyngeal cancer.

The researchers were also surprised to find that heavy smoking and drinking did not seem to add to the risk in people with evidence of oral HPV infection.

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