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Dr. Watwe on HPV and its Link to Oral and Pharyngeal Cancers – Part 1
Recently, HPV (human papillomavirus) has been linked closely to increasing rates of oral and pharyngeal (throat) cancers worldwide. In this post, you will find more information about HPV and its link to the oral cavity. Due to its close relationship to the throat and mouth areas, seeing a dentist yearly for an oral cancer screening can greatly help early detections of such cancers.
What is HPV?
HPV is a group of over 150 viruses, and approximately 40 of these viruses are easily spread through vaginal, anal, and oral sex. HPV has been found to be the most common sexually transmitted infection (STI) in the United States. At some point in their lives, nearly half of the sexually active population of the U.S. have been infected with HPV. Around 14 million people get HPV each year, and around half of these infections happen in teenagers and young adults (age 15-24). Early prevention has proven to be very important as HPV infection can cause genital warts and lead to various types of cancer.
Sexually transmitted HPVs fall into two categories:
1. Low-risk HPVs: Do not cause cancer, but can cause skin warts on or around the genitals or anus. HPV types 6 and 11 cause 90% of all genital warts.
2. High-risk/oncogenic HPVs: Can cause cancer; around 12 different HPVs have been found to be high-risk. The two which are responsible for the majority of HPV related cancers are HPV types 16 and 18.
HPV and its Link to the Oral Cavity
The same types of HPV which can infect the genital area can also infect the mouth and throat since the mucosal soft tissues in these areas are very similar. In most cases, HPV infections of all types go away before they cause any health problems. If one of the low risk HPVs mentioned above infects the oropharynx, the most common symptom is oral warts. However, an infection of one of the high risk HPVs mentioned above could result in Oropharyngeal Cancer, mostly in the back of the throat at the base of the tongue and tonsils.
Head and Neck Squamous Cell Carcinoma (HNSCC) is the eighth most common cancer worldwide with approximately 650,000 new cases reported annually. In the past, trends for HNSCC have generally paralleled smoking trends. Mostly, older men with a history of smoking cigarettes and drinking alcohol for many years used to be the standard patient with oral cancer. However, there has been an increasing incidence of a certain type of HNSCC, specifically oropharyngeal carcinoma in recent years. This increase has been seen even though there has been no parallel increase in smoking and alcohol consumption. This suggests that there are non-traditional behavioral and environmental factors driving the increase in HNSCC. It has been found that up to 70% of oropharyngeal cancers may be caused by HPV, particularly HPV Type 16.
Hence, the traditional risk factors have been replaced by more powerful risk factors relating to sexual practices – the most important being a high number of sexual partners, history of oral-genital sex and history of oral-anal sex. One of the most significant routes of transmission of HPV to the oral cavity is oral anogenital contact. However, it is still uncertain 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, due to its close link to the oral cavity, seeing a dentist for a yearly oral cancer screening (or if any abnormalities are felt in the mouth or throat area) is a very important aspect of early detection. Also, yearly health checkups with a general physician are always recommended.
In the next post, we will discuss some of the symptoms of oropharyngeal cancer and its incidence in our population. If you would like more information, or to schedule an appointment here at Preferred Family Dental, please contact us today.