Does HPV and Oral Sex Cause Throat Cancer?

Person holding DNA swab in young woman's mouth, close up of mouth, studio shot
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It's a misnomer to call HPV the "cervical cancer" virus. It has been known for years that human papillomaviruses are associated not only with genital warts and cervical cancer, but also with various other cancers including anal cancer, penile cancer, and cancer of the vulva.

In recent years, however, scientists have found a strong association with oral cancer, too–specifically cancers of the mouth and throat. Some scientists have even hypothesized that, by 2020, these cancers could even replace cervical cancer as the most common cancer caused by HPV.

HPV Infection as a Risk Factor

Although, worldwide, most mouth and throat cancers are still associated with tobacco use and/or alcohol, studies have begun to show that HPV may be another major source of risk. HPV seems to be particularly strongly associated with cancer of the tonsils, although it is also found in biopsy samples from other sites nearby.

Unlike with cervical cancer, there are many other risk factors for cancers of the mouth and throat. These risks include alcohol and tobacco use.

A research study published in October 2011 found that the incidence of HPV-related throat cancers cases had more than doubled in the the U.S. in the years between 1980 and 2004. Furthermore, the percentage of oral and throat cancers that were caused by HPV grew even faster, as the number of tobacco-related cancers declined over the same 20+ year period.

Oral Sex and Oral Cancer

How does a sexually transmitted virus end up associated with cancers located so far away from the genitals? The answer is probably oral sex. Several studies have shown a relationship between oral sex and the presence of HPV DNA in mouth and throat samples. Other studies have shown a relationship between oral sex and HPV-positive throat cancers, particularly in those individuals who perform oral sex on men.

Taken as a group, these studies are yet another chilling reminder that oral sex is not necessarily safer sex. Various other sexually transmitted diseases can also be spread by oral sex, including herpes, gonorrhea, chlamydia, and syphilis. There is also a benign form of respiratory disease caused by HPV transmission during oral sex. Safer sex techniques should, therefore, be used for oral sex as well as vaginal and anal sex. This is particularly true for individuals with genital herpes or HIV infections since both viruses have been shown to predispose people to acquire HPV.

The Problem With HPV Testing

Scientists have questioned the role of different tests for HPV in predicting cancers at various sites. HPV is not an easy virus to meaningfully test for. Just finding HPV DNA in samples from a mouth swab does not necessarily mean that individuals will develop cancer.

Conversely, many individuals with an HPV-positive throat cancer biopsy test negative not only for HPV DNA in the cells of their mouths but also for anti-HPV antibodies in their blood. In general, it is therefore extremely difficult to articulate the meaning of a positive, or negative, HPV test.

A Word From Verywell

Here are four facts to remember:

  1. HPV, and in particular HPV 16, seems to play a role in the development of a significant number of cancers of the mouth and throat.
  2. Oral sex increases your risk of acquiring an HPV infection in your mouth or throat.
  3. Since the vast majority of HPV-associated throat cancers seem to be caused by HPV 16, it is possible that the HPV vaccine might be useful for prevention.
  4. Although study results are mixed, it seems possible that smoking and alcohol use may interact with HPV infection to increase a person's risk of cancer.
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Article Sources
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