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Can Oral Sex Cause Throat Cancer?

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In an era of HIV and chastity rings, teenagers and young adults – roughly 75% of them – have turned to oral sex as a “less risky” option.

| by Edward C. Geehr, M.D., |

But it’s not safe sex. And while it won’t get you pregnant, it can still get you into big trouble. For the first time ever, researchers at Johns Hopkins University have established a link between oral sex, the human papillomavirus (the same virus that causes cervical cancer) and throat cancer. That adds to a roster of risks already tied to oral sex: herpes, syphilis, gonorrhea, and HIV…

This is scary news for the rising numbers of young people choosing oral sex over intercourse.

One Johns Hopkins professor notes that since 1990, the percentage of male patients at his clinic alone who have had oral sex has risen from 50% to about 75%; for women and girls, from 25% to about 75%.

That’s a huge number exposing themselves to this cancer risk, among other sexually transmitted diseases.

Relatively uncommon, throat cancer is usually associated with smoking and alcohol.

The type linked to the human papillomavirus (HPV) afflicts roughly 11,000 Americans each year, about the same number of new cervical cancer cases.

Throat cancer typically involves the base of the tongue, the tonsils, or the back of the throat.

Because it is so rare among people who don’t drink or smoke, the symptoms – sore throat, swollen glands, or a cold sore – are easy to dismiss, delaying diagnosis and treatment.

The Hazard of HPV
HPV can be found in saliva, urine, semen, and genital secretions.

It is transmitted through sexual, skin-to-skin, and possibly even mouth-to-mouth contact.

The Center for Disease Control (CDC) estimates that 20 million people are infected with HPV and that 50% of sexually active people will eventually be infected. In the United States alone, some five million new infections occur each year.

In fact, the majority of sexually active people eventually come in contact with HPV.

Fortunately, in most cases the body mounts an immune response that eliminates the virus.

But a small portion of people infected with HPV fail to clear the virus, and a subset of those develop cancer.

Earlier studies have linked HPV with head and neck cancers. What the present study establishes, however, is the link between certain high-risk sexual behaviors, oral HPV infection and throat cancers, regardless of other risk behaviors such as drinking and smoking.

The particular subtype of HPV that correlates with throat cancer is known as HPV16.

Researchers estimate that about 18% of women and 8% of men (1%-2% of the total population) carry HPV16.

The study examined 100 people with throat cancer and 200 without it for HPV infection and asked questions about their sexual histories.

After adjusting for other factors such as smoking and drinking, the researchers found that participants who tested positive for HPV were 32 times more likely to have throat cancer.

And those who had one to five oral sex partners were nearly four times more likely to have cancer compared to those who had not.

People with six or more partners were nearly nine times more likely to develop cancer. And it made no difference if the partners were male or female.

Pocket Protection
Abstinence is the only certain protection from HPV.

But contraceptives can help protect you. Previous studies have demonstrated that consistent condom use can reduce the risk of genital HPV infection.

And other studies have shown that infrequent use of condoms with a new oral or vaginal sex partner increased the risk of throat cancer.
A 2006 study in the New England Journal of Medicine found that women who used a condom every time they had sex had a 70% lower risk of HPV infection than those who didn’t.

Although it’s unclear how effective condoms are for preventing oral cancers, using them to reduce the risk is a very smart move.

HPV screening is now a recommended part of cervical cancer screening. But how helpful screening for HPV as part of a throat cancer screening might be is unclear: Even if HPV is detected in the cancer, treatment recommendations such as surgery, radiation and chemotherapy remain the same.

Although no vaccine can treat individuals who already carry the HPV virus, the Gardasil vaccine, does protect against contracting the forms of HPV – including HPV16 – that cause cervical cancer.

But no studies have been done testing the vaccine’s protection against throat cancer.

Moreover, an editorial in the New England Journal of Medicine has questioned the effectiveness of the vaccine at preventing precancerous lesions.

But if vaccination proves to be as effective in preventing oral HPV16 infection as it has in preventing cervical cancer, it may be possible to reduce the incidence of throat cancers.
Condoms may help to reduce risk but offer no certain immunity from infection.

To protect yourself, treat oral sex with the same caution as other forms of sexual contact. Oral sex is not safe sex.

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