Experts have known for years that the
main risk factors for oral cancer are drinking alcohol and smoking or
chewing tobacco. But there is growing evidence that infection in the
mouth/throat with Human Papillomavirus (HPV) is a major cause of oral
cancer. Oral cancers are sometimes called head and neck cancers and
include cancers of the mouth, lip, and tongue, as well as cancers of the
tonsils, esophagus, larynx (voice box), nasopharynx (the area that
connects the nose and throat) and the thyroid gland.
Around
25% of mouth and 35% of the throat cancers are HPV-related, but the
exact figures vary between different studies, possibly due to different
ways of testing for the virus or varying levels of smoking and other
risk factors.
There are more than 100 types of HPV, and around 15 are associated with cancers. These 15 are known as high-risk HPV types.
The
types of HPV found in the mouth are almost entirely sexually
transmitted, so it's likely that oral sex is the primary route of
getting them. The high-risk HPV types are also passed on through vaginal
and anal sex, and are linked to:
Cervical cancer
Vulval and vaginal cancer
Anal cancer
Penile cancer
Laryngeal cancer
Tonsil cancer
Some
can be passed on through skin-to-skin contact and cause warts,
including genital warts. The types of HPV that cause visible warts are
low-risk and are not the same types that cause cancer.
There
is good evidence suggesting that, for some oral cancers, risk factors
may be linked to sexual behavior. These risk factors include:
-Ever having oral sex
-Having oral sex with four or more people in your lifetime
-Among men, first having sex at an earlier age (under 18)
How does HPV cause cancer?
HPV
does not directly give you cancer, but it causes changes in the cells
it has infected (for example, in the throat or cervix), and these cells
can then become cancerous.
Very
few people infected with HPV will develop cancer. In 90% of cases, the
infection is cleared naturally by the body within two years.
Could an HPV vaccine help men as well as women?
Yes.
In the UK, girls aged 12 and 13 are routinely given the HPV vaccine.
This is because it is known that nearly all cervical cancers are
HPV-related and that the vaccine offers protection in women. The vaccine
also protects women from HPV-related vulvar and vaginal cancers.
In
addition, it will probably protect them from anal and oral cancer.
There is currently no conclusive proof that the vaccine will protect
against oral cancer, but it's thought likely because HPV causes mouth,
throat and anal cancer in the same way that it causes cervical cancer.
If
you're worried about oral cancer, see your GP. When mouth cancer is
established, it has fairly clear symptoms, and your GP should be able to
see them by looking in your mouth. If oral cancer is diagnosed early,
it is easier to treat, but about half of these cancers are diagnosed
when the disease has already spread within the neck.
The symptoms of oral cancer include:
1. Red – or red and white – patches on your tongue or the lining of your mouth
2. One or more mouth ulcers that do not heal after three weeks
3. A swelling in your mouth that lasts for more than three weeks
4. Pain when swallowing
5. A feeling as though something is stuck in your throat
Safer oral sex
According
to the third National Survey of Sexual Attitudes and Lifestyles,
carried out in 2010-12, just over 75% of men and women aged 16-44 had
heterosexual oral sex in the previous year.
You
can make oral sex safer by using a condom on a man’s penis because it
acts as a barrier between the mouth and the penis. A dam (a square of
very thin, soft plastic) across a woman’s genitals can protect against
infection.
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