HPV and Oropharyngeal Carcinoma

Cancer caused by HPV represent 5% of all cancers, including all cervical cancers.
Research indicates that infection with this virus is a risk factor for oral and oropharyngeal cancer. In fact, HPV-related oropharyngeal cancer in the tonsils and the base of the tongue has become more frequent in recent years. HPV is most commonly passed from person to person during sexual activity, including oral sex. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of cancers. HPV vaccines protect against certain strains of the virus.

The Human Papilloma Virus (HPV) is a group of more than 150 types of viruses. They are called papilloma viruses because some of them cause a type of growth called a papilloma. Papillomas are not cancers, and are more commonly called warts.

Infection with certain types of HPV can also cause some forms of cancer, including cancers of the penis, cervix, vulva, vagina, anus, and throat. Other types of HPV cause warts in different parts of the body.

HPV can be passed from one person to another during skin-to-skin contact. One way HPV is spread is through sex, including vaginal and anal intercourse and even oral sex.

HPV types are given numbers. The type linked to throat cancer (including cancer of the oropharynx) is HPV16.

Most people with HPV infections of the mouth and throat have no symptoms, and only a very small percentage develop oropharyngeal cancer. Oral HPV infection is more common in men than in women. In some studies, the risk of oral HPV infection was linked to certain sexual behaviors, such as open mouth kissing and oral-genital contact (oral sex). The risk also increases with the number of sexual partners a person has. Smoking also increases the risk of oral HPV infection. At this time the US Food and Drug Administration has not approved a test for HPV infection of the mouth and throat.

People with oral and oropharyngeal cancer linked with HPV infection tend to be younger and are less likely to be smokers and drinkers.

Oropharyngeal cancers that contain HPV DNA tend to have a better prognosis than those without HPV

Risk Factors:

Number of sexual partners: The greater the number of sexual partners, the more likely you are to contract a genital HPV infection; and when engaging in oral sex, this also holds true for oral infections. Having sex with a partner who has had multiple sex partners also increases your risk.

Weakened Immune: Systems: People who have weakened immune systems are at greater risk of HPV infections. Immune systems can be weakened by HIV/AIDS or by immune system-suppressing drugs used after organ transplants


Oral Cancer Signs and Symptoms:

This list considers both oral cancers from HPV and those from tobacco and alcohol

• An ulcer or sore that does not heal within 2-3 weeks
• Difficult or painful swallowing
• Pain when chewing
• A persistent sore throat or hoarse voice
• A swelling or lump in the mouth
• A painless lump felt on the outside of the neck, which has been there for at least two weeks.
• A numb feeling in the mouth or lips
• Constant coughing
• An ear ache on one side (unilateral) which persists for more than a few days.

HPV Vaccines

Two vaccines known as Gardasil and Cervarix protect against the strains of HPV that cause cervical cancers (HPV16 and 18), Garadsil also protects against two versions that cause genital warts (HPV6 and 11). Since they block people from ever getting HPV16, it is not much of a scientific leap to extrapolate that to "if you can't get the virus, you can't get things the virus might cause". Using this logic, many in the science community recommend vaccinating to protect people from the various different cancers associated with the virus such as oropharyngeal. The foundation also believes this to be worth doing, and has advocated at the CDC for vaccination of boys, not only to help reach the point of "herd immunity" in our country protecting our next generation from HPV caused cervical cancers, but also other HPV cancers as well including oropharyngeal.

The National Advisory Committee on Immunization Practices recommends routine HPV vaccination for girls ages 11 and 12, as well as girls and women ages 13 to 26 if they haven’t received the vaccine already. The Gardasil vaccine has also been approved for use in boys and men, 9 through 26 years old.