Featured Research

from universities, journals, and other organizations

Oral Sex Increases Risk Of Throat Cancer

Date:
May 10, 2007
Source:
Johns Hopkins Medical Institutions
Summary:
Researchers at the Johns Hopkins Kimmel Cancer Center have conclusive evidence that human papillomavirus (HPV) causes some throat cancers in both men and women. The researchers found that oral HPV infection is the strongest risk factor for the disease, regardless of tobacco and alcohol use, and having multiple oral sex partners tops the list of sex practices that boost risk for the HPV-linked cancer.

Researchers at the Johns Hopkins Kimmel Cancer Center have conclusive evidence that human papillomavirus (HPV) causes some throat cancers in both men and women. Reporting in the May 10 issue of the New England Journal of Medicine, the researchers found that oral HPV infection is the strongest risk factor for the disease, regardless of tobacco and alcohol use, and having multiple oral sex partners tops the list of sex practices that boost risk for the HPV-linked cancer.

Study author and cancer virus expert Maura Gillison, M.D., Ph.D., first reported the connection between HPV and specific throat cancers in 2000, supporting previous work by other investigators. "We believed the links were strong, but needed to understand which behaviors put people at higher risk," says Gillison.

Gillison added that "people should be reassured that oropharyngeal cancer is relatively uncommon, and the overwhelming majority of people with an oral HPV infection probably will not get throat cancer," says Gillison. Consistent condom use may reduce risk.

In Gillison's study of 100 men and women newly diagnosed with oropharyngeal cancer (located in the tonsils, back of the tongue, and throat), those who had evidence of prior HPV infection were 32 times more likely to develop the cancer. This was much higher than the rate increase of threefold for smokers and 2 -fold for drinkers. Study participants who reported having more than six oral sex partners in their lifetime were 8.6 times more likely to develop the HPV-linked cancer. In a surprising twist, Gillison says their data show no added risk for HPV carriers who smoke and drink alcohol. "It's the virus that drives the cancer," explains Gillison, an assistant professor of oncology and epidemiology at Johns Hopkins. "Since HPV has already disrupted the cell enough to steer its change to cancer, then tobacco and alcohol use may have no further impact."

"It is important for health care providers to know that people without the traditional risk factors of tobacco and alcohol use can nevertheless be at risk for oropharyngeal cancer," says Gypsyamber D'Souza, Ph.D., a co-author and assistant scientist at the Johns Hopkins Bloomberg School of Public Health.

Oral sex, including both fellatio and cunnilingus, is the main mode of transit for oral HPV infection, the investigators say, although mouth-to-mouth transmission remains possible and was not ruled out by the current study.

HPVs also can be transmitted by skin contact and are found in the mucus of the genital tract, and in saliva, urine, and semen. Both men and women contract the ubiquitous virus in equal numbers, which is believed to have infected a large proportion of people worldwide at some point in their lives. Most HPV infections clear with little or no symptoms, but a small percentage of men and women who acquire cancer-causing or "high-risk" strains, such as HPV 16, may develop a cancer. HPV-linked cancers currently include oral, anal, cervical, vaginal, penile, and vulvar cancers.

Gillison said a new FDA-approved vaccine, known by its tradename Gardasil, can prevent genital HPV infection in girls and young women, but has not yet been shown to prevent infection in boys and men. The vaccine's ability to prevent oral HPV infection and oral cancers, which are more common in men, also is not known. Although HPV detection is now added to the Pap smear for cervical cancer screening, there are no screening methods for oral cancers besides visual inspection during annual dental visits. But Gillison says that it's still too early to recommend including HPV detection in oral cancer screening.

Along with an anonymous survey, Gillison and her colleagues sampled participants' blood and saliva. Eighty-six of the 100 patients were male and 14 were female. They collected information on sex practices and other risk factors for the disease, including tobacco and alcohol exposure, family history, and poor oral hygiene. Answers were compared with those of 200 control subjects with benign conditions.

HPV 16 was present in the tumors of 72 percent of oropharyngeal cancer patients enrolled in the study. People with detectable antibodies in their bloodstream to molecules made by HPV were 58 times more likely to have these oral cancers, a figure that dwarfs the connection between high cholesterol and heart attacks. The researchers also were able to find higher risk in patients with traces of HPV in oral rinses, a first step to developing a "swish-and-spit" screening method for at-risk individuals.

HPV-linked oral cancers have been on the rise since at least 1973, and Gillison expects the trend to continue to a point when HPV-associated cancers will far outpace those caused by tobacco and alcohol use. They currently account for 60 percent of oropharyngeal cancers and about a third of all oral cavity and pharynx cancers in the United States, totaling more than 11,000 individuals*.

For those who already have HPV-linked oropharyngeal cancer, there is some good news. Gillison's previous studies, along with others, showed that these patients have a survival advantage with most living well past the five-year mark.

"We're getting more intensive in our cancer treatments and seeing a survival benefit, but it may not be the therapy alone that's causing this. It could also be the increasing percentage of treatment-friendly HPV cancers," suggests Gillison. Researchers would still need to assess how to safely ratchet back therapy, which causes severe swallowing, breathing and talking problems.

As for an oral rinse screening test, its feasibility still remains unproven. For this study, Gillison and her colleagues spent two years refining methods to detect HPV in oral samples. She also is working with manufacturers of the new FDA-approved vaccine for HPV to determine its potential in curbing oral cancers.

Funding for the research was provided by the Damon Runyon Cancer Research Foundation, the Johns Hopkins Cigarette Restitution Fund Program and the National Institutes of Health.

Co-authors include Gypsyamber D'Souza, Ph.D., Raphael Viscidi, M.D., Carole Fakhry, M.D., Wayne M. Koch, M.D., and William H. Westra, M.D., from Johns Hopkins; Aimee R. Kreimer, Ph.D., from the National Cancer Institute; and Michael Pawlita, M.D., at the German Cancer Research Center in Germany.

* American Cancer Society, Facts and Figures 2007.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "Oral Sex Increases Risk Of Throat Cancer." ScienceDaily. ScienceDaily, 10 May 2007. <www.sciencedaily.com/releases/2007/05/070509210142.htm>.
Johns Hopkins Medical Institutions. (2007, May 10). Oral Sex Increases Risk Of Throat Cancer. ScienceDaily. Retrieved July 30, 2014 from www.sciencedaily.com/releases/2007/05/070509210142.htm
Johns Hopkins Medical Institutions. "Oral Sex Increases Risk Of Throat Cancer." ScienceDaily. www.sciencedaily.com/releases/2007/05/070509210142.htm (accessed July 30, 2014).

Share This




More Health & Medicine News

Wednesday, July 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Generics Eat Into Pfizer's Sales

Generics Eat Into Pfizer's Sales

Reuters - Business Video Online (July 29, 2014) Pfizer, the world's largest drug maker, cut full-year revenue forecasts because generics could cut into sales of its anti-arthritis drug, Celebrex. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins