HPV and Oropharyngeal Cancer – Part 2

Posted on February 11, 2015 in Full Body Health

In the first part of this blog series on HPV and Oropharyngeal Cancer, we discussed the different types of HPV and their link to oropharyngeal cancer. In this blog, we will see how HPV causes cancer, how common oral HPV is, explore the signs and symptoms and the process of diagnosis, and discuss the prevention of oral HPV infections and oropharyngeal cancer.

If you have questions about oral cancer screening, or if you would like to schedule an appointment with one of our dentists, please contact Preferred Family Dental today.

How HPV Can Cause Cancer

Most people who are exposed to HPV never develop symptoms or health issues. This virus can cause normal cells in infected skin to turn abnormal. Most of the time, you cannot see or feel these cell changes. In about 70-90% of the cases, the body’s immune system fights off the HPV infection naturally and the infected cells return to normal. But in some cases the infection may persist, remain latent in the body and potentially cause long-term problems. These problems may include cervical cancer in women, penis cancer in men, and in both sexes, some cancers of the anus and oropharyngeal cancer.
Cancer caused by HPV often takes years to develop after initially getting an HPV infection; sometimes, as much as 15 years. As mentioned in the previous blog, it is unclear if having HPV alone is sufficient to cause oropharyngeal cancers, or if other factors (such as smoking or chewing tobacco) interact with HPV to cause these cancers. More research is needed to understand all the factors leading to oropharyngeal cancers; however, some experts predict that oropharyngeal cancers linked to HPV will become more common than cervical cancer by 2020.
Incidence of Oral HPV
Studies have shown that about 7% of the American population have oral HPV, however, only 1% of people have oncogenic HPVs. Also, it has been found that men are three times more likely to have oral HPV than women. In the U.S., around 8,400 people are diagnosed every year with oropharyngeal carcinoma which may be linked to HPV.

There have been very few studies looking at how people acquire oral HPV and some of them have conflicting results. For example, some studies suggest that oral HPV may be passed on during oral sex or open-mouthed kissing, others have not. The likelihood of getting HPV from kissing or having oral sex with someone who has HPV is not known. However, we do know that partners who have been together a long time tend to share genital HPV—meaning they both may have it. The incidence of passing oral HPV by sharing spoons or kissing on the cheek is very low. It is certain that more research is needed to understand exactly how people get and give oral HPV infections.
Signs and Symptoms, Diagnosis and Prevention
Some people may develop some signs and symptoms of oropharyngeal cancer, which may include a persistent sore throat, earaches, hoarseness, enlarged lymph nodes, pain when swallowing, and unexplained weight loss. However, some people show no signs or symptoms.
Currently, there are no FDA-approved diagnostic tools or screening tests for HPVs linked to oral carcinomas. However, it could be surmised that since HPV-16 causes most oropharyngeal cancers (about 90%) and is also linked to many cervical cancers, then the same diagnostic tools could be used for both. At this time, there is no blood test for HPV. However, an HPV DNA test is available. Also, a biopsy of the suspicious area could reveal carcinogenic cells under a microscope.

At this time no studies have explored how oral HPV can be prevented. However, since the main method of transmission has been found to be oral to anogenital contact, it is likely that condoms and dental dams can lower the chances of giving or getting oral HPV if used correctly. It is also possible that the HPV vaccines now on the market can help in the prevention of oral HPV. These vaccines were developed to prevent cervical and other anogenital cancers. These vaccines prevent an initial infection with the types of HPV which can lead to any type of cancer, and hence may also prevent oropharyngeal cancer. However, there have been no conclusive studies to show this for certain.

The Centers for Disease Control recommends that young women get vaccinated against the virus to prevent cervical cancer. The CDC also recommends the vaccination for young men for two reasons: to help prevent its transmission to women, and to help prevent some of the 7,000 HPV-related cancers that occur in men each year. However, vaccination won’t help older people (those beyond their early 20s) or the millions of people already infected with HPV.

If you’ve been infected with the virus, diagnosing an HPV-related oral cancer as early as possible greatly improves the prognosis. See your doctor if you have one or more of these symptoms for more than two weeks:

• A sore in your mouth or on your tongue that doesn’t heal
• Persistent pain with swallowing or sore throat
• A lump in your neck that persists

Contact Preferred Family Dental

For more information, or to schedule an appointment, please contact us today.