HPV Infection and Oropharyngeal Cancer 

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Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

October 26, 2018

Human Papillomavirus (HPV) is an infection which is transmitted sexually and which takes many different forms in humans. The most serious of these are warts and cancers on the genitals, but there are a variety of other issues it can cause as well. Many of the ill health effects caused by HPV can be prevented by vaccines, if those vaccines are administered prior to an encounter with an infected person.

Today in the US, there are approximately 79 million Americans who are infected with HPV, most of whom are in their teens and early 20’s. The most common way to contract the virus is to engage in vaginal, anal, or oral sex with an individual who is already infected with the virus. Unfortunately, there are rarely any observable indications that a sexual partner is infected with the virus.

That makes it possible for literally anyone to become infected by the virus, even if sexual activity is limited to a single partner. It’s also quite possible to begin experiencing symptoms of HPV years after having had sex with a person who was infected. That, of course, makes it extremely difficult to know when you originally became infected, as well as who your partner was at that time.

In most cases, HPV simply goes away eventually on its own, without any kind of medical intervention. Other times, it can cause significant medical issues, including cancer of the vagina, penis, anus, or vulva, as well as oropharyngeal cancer, which occurs well away from the sex organs, in the back of the throat. Oropharyngeal cancer affects the tonsils and the tip of the tongue, and is generally triggered by oral sex, whereas the cancers affecting the sex organs are more commonly initiated by anal or vaginal sex.

HPV and oropharyngeal cancer

Some types of Human Papillomavirus make it much more likely that an individual will develop oropharyngeal cancer (head and neck cancer), during later adulthood. A study which has been published in the JAMA Oncology periodical, states that individuals infected with HPV are 22 times more likely to develop this kind of cancer.

This was a major study involving nearly 100,000 patients, all of whom had infections of the throat, soft palate, tongue, or tonsils. HPV infections are primarily contracted via oral sexual activity, and the HPV virus itself is known to be the cause of at least 70% of all incidents of oropharyngeal cancer diagnosed in the US. The remaining 30% of oropharyngeal cancers are attributable to excessive consumption of either alcohol or cigarettes, or both.

At the time the study was conducted, all participants were free of cancer, and all were asked to provide mouthwash samples which could be analyzed. During a four year follow-up period, a total of 132 instances of oropharyngeal cancer were identified from the mouthwash samples. After a thorough evaluation of all data, researchers were able to conclude that there was a significantly higher risk of oropharyngeal cancer in individuals who had an existing HPV infection of the oral cavity.

Incidentally, the analysis technique regarding the mouthwash samples is now becoming something of a standard test for identifying oropharyngeal cancer. Since this type of cancer is generally diagnosed in a dentist’s office anyway, the mouthwash sampling can be a very convenient and accurate way of administering the test.

Avoiding HPV

There are several things you can do to avoid contracting Human Papillomavirus, including the primary method which is to get vaccinated against it. The HPV vaccine can protect against the development of any oropharyngeal cancer, as well as the development of genital warts and other health issues. The Center for Disease Control recommends that children aged 11 or above be administered two separate doses of the vaccine to avoid the possibility of contracting oropharyngeal cancer and other health problems. Using condoms can protect against some forms of HPV, but not against the oral variety. It can be highly beneficial to limit your number of sexual partners, so as to be relatively sure of not contracting the virus, although even this provides no guarantee.

Diagnosis of HPV

There is no currently accepted method of definitively diagnosing whether a person has HPV or not. However, cervical cancer screenings for women aged 30 and above can identify the presence of the virus, so that steps can be taken to avoid the development of cancer. In addition, the oral version of HPV can be detected through an analysis of a mouthwash sample, as described above in the JAMA Oncology study. Other than these possibilities, your best bet for protection against contracting HPV is to engage in protected sex, limit your sexual partners and get vaccinated at an early age.



Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

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