Sex Practices Driving Surge in HPV-
Linked Oral Cancer

In Stockholm, 93 percent of tonsillar cancers were HPV-positive in 2006-2007

THURSDAY, OCTOBER 14, 2010—Changing sexual practices, including increased oral sex, multiple sex partners, and an early start of sexual activity, are behind an epidemic of oropharyngeal squamous cell carcinoma (OSCC) linked to sexually transmitted human papillomavirus (HPV), according to an article in the November issue of Emerging Infectious Diseases.

Torbjorn Ramqvist and Tina Dalianis of Karolinska Institutet in Stockholm, Sweden, reviewed recent studies, including several conducted by their own institute, on the increased incidence of OSCC. For example, studies by the authors found that tonsillar cancer (the most common OSCC) increased 2.8-fold in Stockholm during 1970-2002 and that 93 percent of all tonsillar cancers in Stockholm were HPV-positive by 2006-2007.

Some studies have shown that patients with HPV-positive OSCC tend to be younger and often lack the traditional risk factors of smoking and alcohol consumption, the authors write, and others have found OSCC risk is linked to increased oral sex, increased numbers of sex partners, and early sexual debut. One study found that open-mouthed kissing also can lead to oral HPV infection. However, patients with HPV-positive OSCC also tend to have a better prognosis than those with HPV-negative OSCC, and vaccines against the culprit virus (HPV16) are currently available.

“Although it will likely take several decades before the effects of HPV vaccination on cancer incidence will be detected, it is crucial to monitor the effects of the present HPV vaccination, not only on the incidence of cervical cancer but also on the incidence of OSCC,” the authors write.

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