The human papilloma virus (HPV) is one of the most common sexually transmitted diseases in the world, with over 14 million documented cases every year in the US alone.
In fact, according to the World Health Organisation, most sexually active men and women will be infected at some point in their lives, with most not even knowing they ever came into contact with HPV.
Many people don’t know they have it
A vast majority of people who contract HPV will suffer no ill effects because, of the 40+ strains of the virus, only a small number have the potential to cause serious health problems. Around 13 strains of HPV have so far been identified as high-risk, in that they have the potential to cause various different types of cancer.
Some types of HPV have been associated with head and neck (oropharyngeal) cancers that affect the throat, mouth, tonsils and back of the tongue. However, it is important to stress that the chances of developing oral cancer from an HPV infection is very rare.
According to data from the United States’ Centers for Disease Control and Prevention (CDC), around 7% of people carry oral HPV. Only 1%, however, have the strain of HPV associated with head and neck cancers and, of these, only a very small number will go on to develop cancer. This is because the immune system is generally very good at flushing the virus out of the body.
How Do HPV-related oral cancers develop and who is most at risk?
Most oral cancers are caused by HPV – specifically, a type known as HPV16 – and they primarily affect the base of the tongue and the tonsils. A much smaller number affect the front of the mouth and the oral cavity.
White, non-smoking males between the ages of 35 and 55 are considered to be at highest risk of developing HPV-related oral cancer. While HPV16 affects both men and women, men are about 4 times as likely to go on to develop oral cancer as a result of infection. A theory about why this might be is because women tend to develop protective antibodies against the virus at an earlier age than men.
Of course, there are other risk factors that go beyond gender. The higher someone’s number of sexual partners, for example, the higher their risk of contracting HPV. In terms of oral cancer, the risk of course increases in line with how often someone engages in oral sex.
Weakened immune systems are another important factor affecting oral cancer rates. People who have weakened immune systems as a result of HIV/AIDS of immune-suppressant drugs such as those used after organ transplants are at a greater risk of HPV infection.
What are the Symptoms of HPV-related Oral Cancers?
The symptoms of oral cancers can be difficult to detect as they are often subtle and painless, regardless of whether they are caused by HPV or other risk factors such as alcohol or tobacco.
Signs to look out for include an ulcer or sore that shows no sign of healing after 2-3 weeks, a white, red or black discolouration on the mouth’s soft tissues, pain or difficult swallowing, a swollen yet painless tonsil, pain while chewing, a persistent sore throat, cough or hoarse voice, a numbness around the mouth or lips, or an earache on one side that persists for more than a just a few days.
Ultimately, any unusual swelling, lumps, or sensations in or around the oral region should be evaluated by a medical professional in order to determine whether they are benign or if further tests need to be carried out.
Other Risk Factors for Oral Cancer
It’s important to note that HPV isn’t the only cause of oral cancer.
Alcohol and tobacco use are other risk factors that could contribute to the development of oral cancer and should be considered much along the same lines as HPV.
How is Oral Cancer Diagnosed?
The best way of testing for oral cancer tends to be through a physical examination and routine questioning by a dentist or doctor, who will evaluate whether further investigations are required.
Dental testing kits are available to determine whether a person has oral HPV. However, as the likelihood of HPV developing into cancer is so low, these kits are generally considered a waste of time, and could cause needless worry.
Can I prevent HPV-related Oral Cancer? What Does it Mean for my Future Health?
It is important for people to realise that most people who have been sexually active at some point in their lives will have come into contact with HPV at some point, a vast majority of whom will have cleared it from their system in less than two years. In this way, HPV alone is not something to worry about.
Indeed, oral HPV infection alone causes no physical symptoms and there are no drugs available to kill it, so there is little that needs to be done by those who may have been exposed.
Individuals with persistent HPV infections are at a higher risk of developing certain types of cancer depending on the location. Safe sexual practices can help lower the risk of contracting HPV, although there are no bullet-proof means of prevention.
Ultimately, the best thing to do is look out for any unusual signs or symptoms and report to your doctor if you are worried. The cancer most commonly associated with HPV is not oral cancer but cervical cancer. For women, it is important to get a regular cervical screening, as these are proven to be very effective at preventing cervical cancer from developing.
There are now vaccines available to protect against the strains of HPV that can cause cervical cancer (HPV16 and HPV18), with some types of vaccine also protecting against the strains that cause genital warts (HPV6 and HPV11).
Millions of girls across developed countries have been receiving these vaccines in recent years in the hope that cervical cancer rates will see a significant drop.
As research surrounding HPV improves, however, medical authorities are starting to advocate for the vaccination of young boys too, to give better protection against a range of cancers for a whole generation of young people. While evidence is not yet conclusive, it is believed that the vaccines may help prevent certain types of head and neck cancer from developing.