Aa
OraRisk HPV Test and HPV spread
Hello doctor,
Wondering what your opinion is of the new OraRisk HPV test dentists are beginning to offer. Patients swish a saline solution for 20-30 seconds and then spit into a test tube that is then sent off to OralDNA's lab. Patients are then given a response on positive/negative status and what type of HPV strain they have.
Here's a link to the test, scroll to bottom of page for HPV test info:
http://www.oraldna.com/OurTests/OralDNATests.aspx
Do you think it'd be a good idea to get this test if I previously engaged in oral sex with someone who later told me she was found positive for the high risk strain of HPV. That was 2 years ago, so I'm wondering if this test would make any difference now. Also, if a patient does test negative now...does that mean their body has cleared the HPV and there is almost zero risk of getting HPV-related oral cancer?
The company seems to trump big numbers like 50% of all oral cancers are HPV related and that a new risk group of young, sexually active white people between the ages of 20-50 are at great risk. Is this just scare tactics to try and drum up sales for testing? Bottom line: is this test practical and safe in your medical opinion?
As a quick side question on the completely ridiculous side but I'm just curious nonetheless: since HPV DNA has been found in urine, can "splash back" during a bowel movement possibly infect the anal region? Also can touching genitals and using the same hand to wipe get the HPV virus into the anus?
Thanks
Wondering what your opinion is of the new OraRisk HPV test dentists are beginning to offer. Patients swish a saline solution for 20-30 seconds and then spit into a test tube that is then sent off to OralDNA's lab. Patients are then given a response on positive/negative status and what type of HPV strain they have.
Here's a link to the test, scroll to bottom of page for HPV test info:
http://www.oraldna.com/OurTests/OralDNATests.aspx
Do you think it'd be a good idea to get this test if I previously engaged in oral sex with someone who later told me she was found positive for the high risk strain of HPV. That was 2 years ago, so I'm wondering if this test would make any difference now. Also, if a patient does test negative now...does that mean their body has cleared the HPV and there is almost zero risk of getting HPV-related oral cancer?
The company seems to trump big numbers like 50% of all oral cancers are HPV related and that a new risk group of young, sexually active white people between the ages of 20-50 are at great risk. Is this just scare tactics to try and drum up sales for testing? Bottom line: is this test practical and safe in your medical opinion?
As a quick side question on the completely ridiculous side but I'm just curious nonetheless: since HPV DNA has been found in urine, can "splash back" during a bowel movement possibly infect the anal region? Also can touching genitals and using the same hand to wipe get the HPV virus into the anus?
Thanks
MEDICAL PROFESSIONAL
Anal HPV is quite common in heterosexual men, not rare. Not as frequent as in gay men, but in a study published just this month, 12% of heterosexual men tested positive for anal HPV. Anal cancer remains quite rare in heterosexual men, however -- although quite common in gay men.
For autoinoculation, I was thinking of superficial contact of the kind that happens through scratching, contact during wiping, etc.
You seem overly concerned about HPV in general. It is a universal virus, and at least 80% of us acquire one sexually transmitted strain at one time or another, and considering the more numerous non-genital types, most likely we all sustain several infections during our lives. The vast majority of infections clear up without ever causing problems -- and that includes the vast majority of infections with the high-risk (cancer causing) HPV types.
In other words, you should be looking at HPV as a normal and expected consequence of human sexuality and, for some HPV types, probably of day-to-day, nonsexual human interactions. You definitely should not be spending a minute of your time worrying about penile, oral, or anal cancers due to HPV.
For autoinoculation, I was thinking of superficial contact of the kind that happens through scratching, contact during wiping, etc.
You seem overly concerned about HPV in general. It is a universal virus, and at least 80% of us acquire one sexually transmitted strain at one time or another, and considering the more numerous non-genital types, most likely we all sustain several infections during our lives. The vast majority of infections clear up without ever causing problems -- and that includes the vast majority of infections with the high-risk (cancer causing) HPV types.
In other words, you should be looking at HPV as a normal and expected consequence of human sexuality and, for some HPV types, probably of day-to-day, nonsexual human interactions. You definitely should not be spending a minute of your time worrying about penile, oral, or anal cancers due to HPV.
Thanks for the response and links for more info.
I was considering switching dentists just so I could have this test done, but it does seem a bit impractical right now, and all of the marketing scare tactics turned me off somewhat--I assume for the most part they are scare tactics. I'll take your advice and sit this one out for now.
Regarding your final paragraph, did you mean to say anal HPV IS rare in heterosexual men who have never had anal sex or, exposure is not rare but anal cancer is? I am prone to pruritus ani and this is listed as one of the potential risk factors along with HPV exposure. Also, does "auto-inoculation" exposure mean shoving one's fingers directly up the anus in the massaging way you described would probably be necessary for exposure or just simply wiping after a BM? I've never engaged in anal sex or shoved any fingers up my anus, but other routes for exposure do slightly concern me--26 year old heterosexual male.
Thanks again doctor, that'll take care of my remaining questions for this thread.
I was considering switching dentists just so I could have this test done, but it does seem a bit impractical right now, and all of the marketing scare tactics turned me off somewhat--I assume for the most part they are scare tactics. I'll take your advice and sit this one out for now.
Regarding your final paragraph, did you mean to say anal HPV IS rare in heterosexual men who have never had anal sex or, exposure is not rare but anal cancer is? I am prone to pruritus ani and this is listed as one of the potential risk factors along with HPV exposure. Also, does "auto-inoculation" exposure mean shoving one's fingers directly up the anus in the massaging way you described would probably be necessary for exposure or just simply wiping after a BM? I've never engaged in anal sex or shoved any fingers up my anus, but other routes for exposure do slightly concern me--26 year old heterosexual male.
Thanks again doctor, that'll take care of my remaining questions for this thread.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
Interesting. This is the first I have heard of this test. From all I understand about oral HPV infections and oral cancer risks, I am highly skeptical that this is a useful screening test in healthy people. Until a lot more research is done, I would advise against its use, regardless of known or suspected oral-genital exposure to someone known to have HIV, including high risk types. Doing a quick search of the medical/scientific literature, at the moment I can find nothing about a) how well this test works in detecting HPV of the oral cavity, b) how frequently it is likely to be positive, c) whether it has any prevention value, whether positive or negative.
Here are two threads that summarize some of the issues around throat cancer, HPV, and oral sex:
http://www.medhelp.org/posts/STDs/HPV-and-oral-cancer-risk-in-male/show/1181303
http://www.medhelp.org/posts/STDs/hpv-and-oral-cancer/show/758844
HPV related oral cancers remain rare, despite the media hype. Testing on the basis of known oral exposure to HPV would seem to make no sense. For every person who knows s/he had such an exposure, there probably are 10 times that many who were orally exposed to high risk HPV and never knew it. Therefore, screening reommendations probably would have to include everybody or nobody, and almostd certainly should not be based on exposure history. Until substantial more reserach is done, I would not know what to advise someone with a positive result, even for HPV-16 (which is the only sexually transmitted HPV type yet known to be associated with oral/throat cancer); nor would I confidently reassure anyone with a negative result that they aren't at risk.
As the threads make clear, there is a lot that isn't known about oral HPV and cancer, and current advice, use of screening tests, the role of HPV immunization in prevention, and other unknowns may become clear in the next few years. But for now, I do not think there is a role for oral HPV testing, at least not as a screening test in healthy persons.
As for your last question: anal HPV is not rare in heterosexual men or other persons who have never had anal sex. The exact explanations are unknown. I suppose it is theoretically possible that toilet splash could contribute, but I doubt it. For the most part, HPV probably has to be massaged into the tissues it infects; superficial contact probably is unlikely to transmit the virus. Therefore, my guess is that most anal infections are due to indirect sexual contact, auto-inoculation with one's own fingers, etc.
I hope this helps. Best wishes-- HHH, MD
Interesting. This is the first I have heard of this test. From all I understand about oral HPV infections and oral cancer risks, I am highly skeptical that this is a useful screening test in healthy people. Until a lot more research is done, I would advise against its use, regardless of known or suspected oral-genital exposure to someone known to have HIV, including high risk types. Doing a quick search of the medical/scientific literature, at the moment I can find nothing about a) how well this test works in detecting HPV of the oral cavity, b) how frequently it is likely to be positive, c) whether it has any prevention value, whether positive or negative.
Here are two threads that summarize some of the issues around throat cancer, HPV, and oral sex:
http://www.medhelp.org/posts/STDs/HPV-and-oral-cancer-risk-in-male/show/1181303
http://www.medhelp.org/posts/STDs/hpv-and-oral-cancer/show/758844
HPV related oral cancers remain rare, despite the media hype. Testing on the basis of known oral exposure to HPV would seem to make no sense. For every person who knows s/he had such an exposure, there probably are 10 times that many who were orally exposed to high risk HPV and never knew it. Therefore, screening reommendations probably would have to include everybody or nobody, and almostd certainly should not be based on exposure history. Until substantial more reserach is done, I would not know what to advise someone with a positive result, even for HPV-16 (which is the only sexually transmitted HPV type yet known to be associated with oral/throat cancer); nor would I confidently reassure anyone with a negative result that they aren't at risk.
As the threads make clear, there is a lot that isn't known about oral HPV and cancer, and current advice, use of screening tests, the role of HPV immunization in prevention, and other unknowns may become clear in the next few years. But for now, I do not think there is a role for oral HPV testing, at least not as a screening test in healthy persons.
As for your last question: anal HPV is not rare in heterosexual men or other persons who have never had anal sex. The exact explanations are unknown. I suppose it is theoretically possible that toilet splash could contribute, but I doubt it. For the most part, HPV probably has to be massaged into the tissues it infects; superficial contact probably is unlikely to transmit the virus. Therefore, my guess is that most anal infections are due to indirect sexual contact, auto-inoculation with one's own fingers, etc.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
