Avatar universal

HPV/Oral Cancer

Hello Doctor,
I began seeing articles pop up a few months ago talking about the rise in head/neck cancers due to HPV, specifically HPV-16. Many of the articles and studies done on throat cancer due to HPV seem to implicate oral sex as a major risk factor.

I began to get worried about my risk factors after reading so many articles and thinking about my sexual past. I have only had a sexual relationship with one girl, around 6 years ago when I was still a teenager. We never had sexual intercourse, but we frequently practiced mutual masturbation (both ways) and had oral sex (again, both giving and receiving) a number of times, but probably no more than ten. It was a while ago, like I said, so my memory of the situation isn't too clear.

I am concerned that my giving oral sex to a former girlfriend when I was in my late teens will lead to throat cancer. I am frustrated because there does not seem to be any way to find out whether or not one has oral HPV.

I am aware that HPV is common and most cases of it clear up without causing symptoms or major health problems. Since I feel like I have been relatively healthy over the years (don't drink or smoke), is it reasonable to think that if I contracted oral HPV it would have cleared up on it's own? What typically causes the 'persistent' infections that lead to throat cancer?

Some more things to consider:

-I had my tonsils removed three years ago (don't worry - it wasn't because of this) - would this influence my risk for HPV-related cancer? Lessen it, perhaps?
-My girlfriend at the time was also a virgin (I think), but had experienced oral sex and mutual masturbation with someone before me. Is genital HPV-16 possible in someone who has only experienced mutual masturbation and oral sex?

I'm aware that I probably sound paranoid and ridiculous, but I haven't been able to stop worrying about this. I don't plan on engaging in oral sex again. Any insight will be greatly appreciated. Thank you.
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239123 tn?1267647614
Welcome to the forum.

There have been a fair number of questions on the forum about oral sex, oral HPV, and throat cancer.  The first media attention to these issue began several years ago, although it may have peaked 1-2 years ago.

The bottom line is that there are millions upon millions of oral sex events every year in the US, and yet only a few thousand cases per year of HPV-related throat cancer.  So on the basis of simple statistics, the risk for any particular person is very, very low.  In addition, even though there appears to be an association of oral HPV-16 infection (among the 100+ HPV types, that's the only one associated with throat cancer), I would stress *association*.  It isn't actually clear that most oral HPV-16 infections are actually acquired that way.

You don't say how old you are, but I would guess that by age 30 around 70-80% of Americans have performed oral sex 100 or more times, typically on several different partners.  Whatever the true numbers -- these are only a guess -- your oral sex exposure has been trivial, and it has been with a partner who is very unlikely to have had genital HPV at the time -- and especially unlikely to have had HPV-16.

I'm not aware of any data on tonsillectomy and the risk of oral HPV-16 or throat cancer.  If anything, I would suspect it might lower the risk -- but maybe not, and certainly not by very much.  It's probably a non-issue one way or the other.

In summary, this really isn't something you should be remotely worried about.  It is a gross overreaction to plan on never having oral sex.  If you and your partner(s) find it pleasurable, HPV is not a reason to exclude it from your repertoire of sexual practices.

For further reading, below are links to two other threads that discuss these and related inssues in even more detail.

Regards--  HHH, MD

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Avatar universal
Thank you for your reply. I am 24 years old, the relationship I'm describing would have been when I was 18. Some follow-up questions:

Is it reasonable to expect that an HPV throat infection (however unlikely) would be cleared by now if I had received it at 18 if I am generally healthy?

You are stressing that it is only an association regarding HPV-16 - does this mean that it is only an association (not concrete proof) that HPV-16 is transmitted via oral sex, or only an association that HPV-16 causes throat cancer?

Despite the low odds, 10,000 still seems like a lot of people. Does it make sense to think that these 10,00 would have avoided cancer if they had avoided oral sex? If so, wouldn't that be enough of a reason to advise couples to abstain from oral sex?

Thank you for your comments
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239123 tn?1267647614
Most HPV infections clear up spontaneously within several months to a couple of years.  As I said, it is very unlikely you were exposed to (or caught) HPV from the exposure described, but if you did, most likely any HPV infection cleared up years ago.

My "association" comment was in regard to oral sex.  Technically, it is also true that HPV-16 is only "associated" with throat cancer -- but most likely it is the direct cause of the malignancy.

If 10,000 seems like "a lot" in a country of 360 million, you'd better study your math.  It is one of the rarer cancers.  The odds are 40-50% that cancer is what will take you from this world someday.  But the chance it will be HPV related is exceedingly low.  Most likely it will be a common cancer, like colon, rectum, lung, prostate, or any of the others that are much more common than HPV.

Whether or not the 10,000 annually would have not had those particular cancers if they had avoided oral sex isn't known.  But what IS known is that the vast majority (maybe 99.9% or more) of people who perform oral sex never get throat cancer.

If you're going to worry about preventable health problems, I suggest you concentrate on those that have a realistic chance of harming you -- like wearing seat belts, not smoking, having smoke alarms in your home, and keeping firearms out of the house (or at least under lock and key).  Why spend any energy worrying about something that has less chance of killing you than lightning?

That will end this thread.  I'm not going to play speculative games about nearly zero risk health outcomes.
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239123 tn?1267647614
I meant to also say you can be vaccinated against HPV.  Two vaccines are available, and both protect against HPV-16.  Discuss it with your doctor.
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Avatar universal
Thank you for your response - well noted your comments. I saw the articles and they caused me to worry when my partner at the time brought them up in passing. Like I said, this was a while ago (when I was 18, my partner was 20) and now perspective is beginning to sink in.
Thanks again
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