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STDs (Expert Forum)
Recent studies linking HPV to Oral Cancer.
Answered by
University of Washington
Seattle - WA
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This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Recent studies linking HPV to Oral Cancer.
by GV, Jan 12, 2006 12:00AM
Hello. I am a 28 year old hetrosexual male. Recent clean physical. I got genital warts almost about 1.5 years ago, but have been free of any visible warts for at least 8 months.
This is more of a science question.
We have known for years the risk of HPV infection and cervical cancer and now we know there is an associated risk for oral cancer.
One thing that no article I found stated was the following:
If you have physical symptoms of HPV (i.e. visible warts, oral or genital) and you get over them, meaning you go for an extended period of time with no visible warts ... then does that mean your HPV infection has increased your chance of oral cancer down the road?
If you have "cured" the infection, then doesn't that mean you have thus avoided the development of oral cancer from HPV?
I would think that your risk of HPV related oral cancer is strongest during an active HPV infection (i.e, possible lesions developming maligant abdnormalities). This would account for the increase in younger individuals developing oral cancers, but if you are over it, then you are over your HPV related cancer risk...no?
Maybe the issue is that it is difficult to tell when an active HPV infection begins and ends when there are no visible symptoms. But if you have a clear pap and you have no visible warts after 6 months or more, and you no longer expose yourself to new strands ... I would think you are hard pressed to go to the dentist 5 years from now and find out you have oral cancer?
Your thoughts?
best
This is more of a science question.
We have known for years the risk of HPV infection and cervical cancer and now we know there is an associated risk for oral cancer.
One thing that no article I found stated was the following:
If you have physical symptoms of HPV (i.e. visible warts, oral or genital) and you get over them, meaning you go for an extended period of time with no visible warts ... then does that mean your HPV infection has increased your chance of oral cancer down the road?
If you have "cured" the infection, then doesn't that mean you have thus avoided the development of oral cancer from HPV?
I would think that your risk of HPV related oral cancer is strongest during an active HPV infection (i.e, possible lesions developming maligant abdnormalities). This would account for the increase in younger individuals developing oral cancers, but if you are over it, then you are over your HPV related cancer risk...no?
Maybe the issue is that it is difficult to tell when an active HPV infection begins and ends when there are no visible symptoms. But if you have a clear pap and you have no visible warts after 6 months or more, and you no longer expose yourself to new strands ... I would think you are hard pressed to go to the dentist 5 years from now and find out you have oral cancer?
Your thoughts?
best
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 12, 2006 12:00AM
, Jan 12, 2006 12:00AM
The title of your thread suggests you have seen my other comments on recent research showing that oral cancer seems to be increasing in frequency and that, surprisingly, most of the HPV types now associated with oral cancer are the same ones that typically are sexually transmitted and associated with cervical, other genital, and anal cancers--HPV-16, 18, etc. These facts seem to be true, and they suggest (but definitely do not prove) that changing patterns of oral sex may influence the risk of oral cancers. They also imply (but do not prove) that genital HPV infection may be more frequently transmitted to the oral cavity than previously believed.
However, even with the apparent increase in oral cancer, the actual risk is very low. Oral cancers are rare--far less common, for example, than malignancies of the breast, cervix, prostate, lung, skin, etc, etc. An increased risk of a rare outcome still means the outcome is rare.
The available data do not permit definitive answers to your questions. Genital warts per se are not the issue, though; different HPV types cause warts (mostly HPV-6 and 11) than cancers 16, 18, etc). Also, the time frames you imply in your question probably are not relevant. It is likely that oral cancers, like most cervical cancers, occur many years (10, 20, maybe 30 yr) after initial infection, not within 5 years.
Would avoiding oral sex, and/or avoiding oral contact with a partner with genital HPV infection, reduce one's risk of oral cancer in the future? Nobody knows. But for the moment, it is safe to assume the risk is low enough that nobody should lose sleep over it, and nobody should alter their sexual practices in the hope or expectation it will reduce an already miniscule risk to an even lower level. If the association is real, the likely resolution--someday in the future--probably will depend on the soon-to-be-marketed vaccines against genital HPV infection.
Regards-- HHH, MD
However, even with the apparent increase in oral cancer, the actual risk is very low. Oral cancers are rare--far less common, for example, than malignancies of the breast, cervix, prostate, lung, skin, etc, etc. An increased risk of a rare outcome still means the outcome is rare.
The available data do not permit definitive answers to your questions. Genital warts per se are not the issue, though; different HPV types cause warts (mostly HPV-6 and 11) than cancers 16, 18, etc). Also, the time frames you imply in your question probably are not relevant. It is likely that oral cancers, like most cervical cancers, occur many years (10, 20, maybe 30 yr) after initial infection, not within 5 years.
Would avoiding oral sex, and/or avoiding oral contact with a partner with genital HPV infection, reduce one's risk of oral cancer in the future? Nobody knows. But for the moment, it is safe to assume the risk is low enough that nobody should lose sleep over it, and nobody should alter their sexual practices in the hope or expectation it will reduce an already miniscule risk to an even lower level. If the association is real, the likely resolution--someday in the future--probably will depend on the soon-to-be-marketed vaccines against genital HPV infection.
Regards-- HHH, MD
Member Comments (2)
by monkeyflower, Jan 12, 2006 12:00AM
I think you'd be hard pressed to go to the dentist five years from now and find out you have oral cancer, no matter what. Oral cancers are pretty rare and I personally think not at all worth worrying about.