STDs Expert Forum
HPV TYPE 16 & ORAL CANCER RISK
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HPV TYPE 16 & ORAL CANCER RISK

Hi
I'm a virgin, and my girlfriend.. whom I've never been sexual with, just told me she has HPV type 16 and 3 other types none of which are the the genital warts causing strains. She was very worried telling me about this, but when she told me.. i was very accepting understanding and honestly felt like it was no big deal, cause after my brief reading, aside from the genital warts causing strains.. i thought there is no effect to males, its just if i were to have unprotected intercourse with her i may than pose a risk of giving future girlfriends cervical cancer.
Well i thought i should read about HPV more and if there are any concerns related to it on my end besides what i thought. And i discovered there is a link between HPV 16 and oral cancer.. and also penile cancer. Now im worried and thinking i shouldnt give her unprotected oral sex. I really want to give her oral sex. So my first question to you is, i know its hard, but could you give me some kind of ballpark odds like (1 out of a 100 type thing) of performing oral sex on a woman carrying HPV 16 and then developing oral cancer? i think from what i read in the HPV archives here, it seems low, but an odds type figure or some reaffirmation from you would help me feel more comfortable.
Also what is the risk or odds of developing penile cancer from having sex with someone with HPV 16?
What is the risk of contracting HPV 16 having unprotected intercourse with a carrier?
Can somehow her non wart causing strains, manifest warts on me?
Also I was curious what are the odds of a person in their lifetime of getting specifically the HPV type 16 strain.. i think i read something like 75% of people will carry any type of genital HPV infection at some point in their life.

THANK YOU, I deeply appreciate your insight
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Thanks for doing some homework on HPV.  And congratulations for having an objective, analytic perspective on your girlfriend's HPV infection, rather than panicking and/or rejecting her.  You sound like a mature and sensitive young man.  However, you have come away with an inflated view of how dangerous HPV is, including type 16.

My first comment is to wonder whether your girlfriend really is known to have HPV-16; and she clearly doesn't have 3 wart-causing types (only 2 types, HPV-6 and -11, cause over 90% of genital warts).  And unless she is in a research study, it seems unlikely the exact type(s) of her HPV infection are known; the standard tests done with pap smears just tell 'high risk' versus 'low risk' (wart-causing) infection.

My second comment is that your first impression, that the situation is not a serious threat to your health, was closest to the truth.  You are right that you can expect to be infected with HPV, probably several types, during your coming sexually active years.  Although HPV 16 is statistically associated with cancers of the mouth and throat, that remains a rare disease, as you found from the forum archives--but I can't put a number to the risk, there are no such data.  Penile cancer is even rarer, and neither of these should be a serious consideration in your sexual choices.  But if your partner indeed has a wart-causing HPV infection, you certainly could get genital warts.

You don't say how long ago your partner was diagnosed and whether she has been treated.  If all this goes back several months or more, she may no longer be infected.  If it was more recent and you go ahead with sex in the near future, either genital or oral, you can expect to be infected with HPV.  If that happens, you probably will never know it; the most likely outcome is an asymptomatic infection that goes away and never is a problem for you.  However, you could get genital warts if she has HPV-6 or 11.  (Oral warts are possible but rare.)  Of course for vaginal sex, condoms would reduce your risk of infection; and to maximize safety for oral sex, you could use plastic wrap or a dental dam (although many people find those measures more hassle than they are worth).

Bottom line:  You need to make your own decision.  You also could be immunized with the HPV vaccine, which protects against HPV-6, 11, 16, and 18.  But it's expensive and not yet approved in men--probably will work and safe, but insurance won't cover it; and it takes 6 months to be effective, so doesn't help much with short term decisions.

Congratulations again for a responsible attitude.  Good luck--  HHH, MD

PS:  I think you hit Enter more than once.  I deleted the duplicate question.  Use the contact link to ask MedHelp administration to reimburse your credit card for the extra posting.
4 Comments
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Thank you so much for your response, and quick too!

"Thanks for doing some homework on HPV. And congratulations for having an objective, analytic perspective on your girlfriend's HPV infection, rather than panicking and/or rejecting her. You sound like a mature and sensitive young man."

Thank you, so much, that is very nice of you to say, I worry though that maybe I wont have been so easy going had I known about the oral cancer risk that i subsequently grew concerned about after digging it up the next day on the net. Though now, worry about that risk is fading some, i think.. i just thought of how prevalent unprotected oral sex is, how females perform it on males who are unknowingly carrying high risk HPV types. Seems to be extraordinarely common place, yet no girls and guys I know of have mouth cancer.
Can you tell me what percentage of the sexually active population carry the high risk cancer causing types of HPV? or some figure to that affect?

Maybe that contrasted against the frequency i know that unprotected oral sex is performed among the sexually active would put into perspective the low risk of oral cancer developing that way.

Why do you say "neither (oral cancer or penile cancer) should be a serious consideration in your sexual choices"?
I know you say they are rare,.. I'm just looking for maybe you to expound upon that a little bit, by what rare means.. rare can be a wide range. sorry, im a worry wart.. i want to feel the assurance you do.


"My first comment is to wonder whether your girlfriend really is known to have HPV-16;"
Well about a year ago about she had what was the beginning of cervical cancer, she had something removed, perhaps a lesion..(i know in my online homework i came across the term for what this probably was, but it fails me now). She was placed in like an extremely high risk group of women to develop cervical cancer and has had to go in for monthly pap smears.
She told me a few days ago, when she told me about having HPV, that she has 4 types, none of them are the wart causing types.. but one she labeled as being the highest cancer risk causing type.. and then through my homework i just assumed that, that was HPV 16 or 18.

If i were to give her unprotected oral, and i then give unprotected oral sex to another girl months later could i transmit the high risk HPV to her?


About the HPV vaccine, because im a man.. can I not get it yet? I would like to. I went to merck website and it said for girls between 11-26 or something to that affect which i found really curious, why not males too?

THANK YOU SO MUCH, I DEEPLY APPRECIATE ALL YOUR HELP! What you do and have done in this forum, cumulatively, has provided an incredible and indispensable resource of information for all on the internet.
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Excuse me.  But at your apparently young age, worrying about oral cancer and the risks of oral sex harming your health (due to HPV or anything esle) is like worrying about an upcoming trip to the zoo because a cage might break and you'll get eaten by a lion.  It could happen.  So what?

Look at HPV infection as inevitable.  You're going to get it; we all do.  You're probably going to be infected with one or more high-risk, cancer causing types:  that also happens to most of us.  There's probably a good chance of a high-risk oral HPV infection sometime in your life:  we really don't know how frequently that happens, but it isn't rare.  But if you want the HPV vaccine, you can get it regardless of not (yet) being approved for use in men.  That's not a legal issue; it just means insurance won't cover it and you'll have to pay somewhere around $500-600 for the vaccine itself plus office fees.

Your risk of dying of skin cancer 50 years from now is many times higher than your risk of oral cancer, regardless of what you do about HPV.  So if you're going to be concerned about the latter, I have to assume you never go outdoors--even in cloudy weather--without wearing 30+ SPF sunscreen.

Put life's risks in perspective.  Protect your health in ways that address easily preventable, high risk events--that is, use condoms, protect yourself from injury (seatbelts, smoke alarms, firearms), stay in good physical condition, eat right, don't smoke--and let the rest of life's risks come at you as they will.  You can't do anything about them anyway, so why worry?

HHH, MD
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