Oral sex can get most men’s attention. This topic becomes much more medically relevant, however, when coupled with a new study linking human papillomavirus (HPV) to an increased risk of a specific type of oral cancer more often seen in men.
A recent study which appeared in the New England Journal of Medicine (NEJM) showed that men and women who had six or more oral-sex partners during their lifetime have a ninefold increased risk of developing cancer of the tonsils or at the base of the tongue. Those infected with HPV were also 32 times more likely to develop this type of oral cancer than those who do not have the virus.
The two additional risk factors which predispose people to developing this oropharyngeal cancer are smoking (3 times greater risk) and drinking (2.5 times greater). HPV drives cancerous growth, as it is well known to do in the cervix. But unlike cervical cancer, this type of oral cancer is more prevalent in men.
HPV is the most prevalent sexually transmitted infection (STI) and affects 50% of sexually active adults over their lifetime. Merck’s vaccine Gardasil protects against 4 strains of HPV out of the 40 known strains which are in the mouth and genital tract. Furthermore, only one-third of teen girls and young women who start the 3 dose series actually finish. Nearly three-quarters don’t start it at all.
In 2009, Gardasil was approved for use among boys and men aged 9 to 26 and a newer study by Merck found that males in this age group were 66% less likely to contract genital warts caused by HPV infection from the 4 strains of HPV that Gardasil protects against. Early in 2011 the American Academy of Pediatrics included HPV vaccines in its list of recommended vaccines for children and teens.
Proponents of routine HPV vaccination say that inoculating men contributes to immunity which helps protect women also. While we commonly attribute HPV as being implicated in cervical cancer in women, researchers at Johns Hopkins say “When you look at the cancers associated with HPV in men (including penile cancer, anal cancer and oral cancer) it’s very close to the frequency of cervical cancer occurring in women every year.
In yet another study in the NEJM, as effective as Gardasil is against a few specific HPV infections, the vaccine is only 17% effective against cancer precursors overall. Researchers at the Dana-Farber Cancer Institute have seen an increase in the number of young people developing oral cancer, people in their 30’s and 40’s. “The idea that oral sex is risk-free is not correct. It comes with significant risks, and developing oral cancer is one of them.”
Dentists are doctors of the mouth and as such, are the ideal professionals to perform routine oral cancer screenings with the VELscope. This is a new device specifically designed to detect pre-cancerous changes very early in the transformation of normal, healthy cells to cancerous cells. Dr. Peltzer believes in doing pre-cancerous screenings on all dental patients as part of our service to our patients.
I’ve displayed this video before but I feel it is so powerful and informative it should be seen again:
New England Journal of Medicine http://cebp.aacrjournals.org/content/17/4/805.long