Oral Sex Linked to Rise in Men's Throat Cancer


Several deaths associated with the vaccine led doctors to advise caution in the rush to promote widespread use of the vaccine, and doctors say there is a lack of public awareness of its role in preventing cancer.

"With any new vaccine, you have to err on the side of caution, but every year we know more about it," said Deeken. "But we have to ask the question: What do we do for the spouses and kids of our patients? I don't see any downside to vaccination at this time. My son and daughter will get it."

Because humans are the only reservoir for HPV, "it could be eliminated like smallpox," he said.

The research isn't new, but it has not received wide attention, perhaps because of taboos associated with oral sex.

Oral sex has become more commonplace; people have more sex partners and have sex earlier in life -- all behaviors linked to HPV-related oral cancers, according to a study in the Centers for Disease Control and Prevention's (CDC) Emerging Infectious Diseases report.

A study at the Swedish Karolinska Institutet showed the risk of developing oral HPV infection increased with a rise in lifetime oral or vaginal sex partners. It also cited "open mouth kissing."

The study included 542 American students, and noted similar increases in such cancers in Britain, Finland and The Netherlands.

But Dr. Kevin Cullen, director of University of Maryland's Marlene and Stewart Greenebaum Cancer Center, is not sure only oral sex is to blame.

"It's hard for me to believe sexual behaviors have changed that much in 15 to 20 years," he said. "It may be that as happens, epidemics get enough people infected and an infection begins to take off, and that may have happened with HPV at some point."

A study Cullen did last year found that HPV-related oral cancer in African Americans were less common than whites, perhaps because of negative cultural attitudes about oral sex.

"But it looks like blacks are beginning to catch up with whites," said Cullen.

Scientists also don't know why women tend to develop cervical cancer while men have more throat cancer. "Maybe women are better able to transmit to a man than a man to the oral mucosa of a woman," said Cullen.

Doctors also think that cancer is likely to develop in the first area of exposure ? in women, usually the vagina. The woman may then develop later immunity in the throat.

But with more oral sex, often before vaginal sex, female throat cancers could increase, they say.

Very little HPV was seen until the 1980s. "It was very rare in our archives," said Cullen. "But each year we looked, it was more prevalent. Why, no one is really sure."

And doctors say those numbers have not yet peaked.

"There is increasing evidence that boys as well as girls should be vaccinated," said Cullen. "Men and women are increasingly going to face the burden of cancer, and we have a tool to prevent it."

Why the medical community has not fully embraced vaccination is not clear.

"The lead time for development of oral cancer is in decades, so to do definitive studies would take decades to do," he said. "[The FDA] picked the simpler task of preventing HPV warts in the short time frame."

Resistance has also come from safety concerns, as well as the fear by some groups that vaccination for a sexually transmitted disease will promote sexual behavior.

Cervical cancer just may just be "sexier" than throat cancer, said Dr. Ranit Mishori, a family physician in the Georgetown University School of Medicine.

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