Recent studies suggest that men have a particularly high prevalence of high-risk oral human papillomaviruses (HPV), which can lead to cancer. There are more than 150 types of HPV, and while certain strains can cause benign growths like warts, a limited number can cause cancer at different anatomical sites, including the mouth, throat, anus, cervis and penis.
Oral HPV is a sexually transmitted virus and can be contracted through oral sex with an infected person.
Who’s at risk?
Amongst men, those who have had many lifetime oral sexual partners have the greatest risk of carrying such high risk HPV strains. While the number of tobacco-related head and neck cancers have declined in the U. S. thanks to a growing awareness of smoking-related risks, the incidence of oral cancer in men is still growing as a result of HPV. This rise was most notable in men aged 50-59, and these trends are anticipated to increase over the next 40 years, making oropharyngeal cancer a significant health concern.
HPV and Cancer
While most high-risk HPV infections go away within 1-to-2 years, and do not cause cancer, certain HPV infections can persist for many years. Persistent infections with high-risk HPV types can lead to cancer. HPV is so common that nearly all men and women get it at some point in their lives and are asymptomatic and never know. In most individuals, their immune system clears the infection. However, in some people the virus lingers in certain tissues like the oropharynx.
Screening and Prevention
While it is possible to identify the virus by analyzing saliva, this test is not yet part of routine screening practice and is being predominantly used in research settings.
HPV vaccination can reduce the risk of infection by the HPV types targeted by the vaccine. These vaccines provide strong protection against new HPV infections, but they are not effective at treating established HPV infections or disease caused by HPV. For them to be effective, individuals need to be vaccinated prior to being exposed to such viruses.
Currently the Gardasil vaccine is approved for use in in males and females ages 9 through 26. Given this age range, the vaccinations and discussions regarding the vaccine are largely being performed by pediatricians, primary care physicians and obstetricians and gynecologists.
Additionally, correct and consistent condom use may reduce HPV transmission between sexual partners. However, because areas not covered by a condom can be infected by the virus, condoms are unlikely to provide complete protection against the infection.
In regards to cancer, there are oral cancer screening programs available and while there are no current treatments for the HPV virus itself, there are a number of excellent curative treatment options for HPV-related oral cancer such as surgery and/or radiation-based treatments depending on the site, stage and health of the patient. Chemotherapy may added to radiation treatment in more advanced cases. HPV related oral cancers have a very favorable prognosis with modern treatments.
Richard Bakst, MD, is an Assistant Professor of Radiation Oncology at the Icahn School of Medicine at Mount Sinai. Dr. Bakst is a board-certified radiation oncologist whose clinical practice is focused on the treatment of patients with head and neck cancer, lymphoma and breast cancer.