There are reasons to get an HPV vaccine - it literally prevents cancer - but consumer marketing is misstating absolute and relative risk when it comes to throat cancer. A preventive vaccine against HPV types, 6, 11, 16, and 18 has been in widespread use for a decade, and a version that also protects against five other HPV types was FDA-approved in 2014. Those vaccines won't clear existing HPV infections.
The prevalence of throat (oropharyngeal) cancers attributed to the human papilloma virus (HPV) has increased in recent decades, but the risk of developing throat cancer is low. It's statistics that have changed. Decades ago such cancers would have been attributed to second-hand smoke or a cigar or pollution. So it is true that some groups are much more likely than others to have the oral HPV infections that can cause these cancers, but that doesn't show causation.
Don't get a panic attack about throat cancer. Despite calls to try and identify people who are at high risk for HPV-related throat cancer, such testing is not justified at this time according to new research.
HPV is transmitted to the mouth and throat mostly by performing oral sex and appears to cause about 70 percent of oropharyngeal cancers. These cancers appear at the back of the throat, base of the tongue, or tonsils. Each year in the U.S. there are about 12,000 cases of these HPV-associated cancers, more than 80 percent of them in men, according to the Centers for Disease Control and Prevention. Since the 1980s, HPV has been increasingly associated oropharyngeal cancer, and in the past two decades has doubled among men.
Using 2009-14 behavioral and medical data from the National Health and Nutrition Examination Survey (NHANES) of 13,089 adults--data that included oral HPV tests - researchers found that Oral infections with the dozen HPV types known to cause oropharyngeal cancer (especially HPV 16, the type that causes most throat cancers) were present at low prevalence in every defined group in the study, the researchers found. Women ages 20 to 69, for example, had a frequency of infection of just over 1 percent, compared to 6 percent for men ages 20 to 69. Men ages 50 to 59 were most likely to have an infection (8.1 percent) of any age group.
Oral sex was clearly associated with a higher prevalence of infection, the researchers found, although the highest infection prevalence was seen only among men. Women with 10 or more lifetime oral sex partners had a relatively low, 3.0 percent prevalence of infection, whereas for men with 10 or more lifetime oral sex partners the figure was 14.4 percent. Prevalence of infection for those reporting zero or one lifetime oral sex partner was consistently low, (between 0 and 2.4 percent).
Smoking also was associated with higher oral HPV prevalence. Prevalence was 14.9% among men who smoked and reported five or more lifetime oral sex partners, compared to less than half that (7.3 percent) for men who reported five or more lifetime oral sexual partners but did not smoke.
Infection with any potentially cancer-causing HPV type is not as predictive of cancer risk as it may seem, the researchers note. In part, that is because some HPV types are much more cancer-causing than others. In fact, one type--type 16--is thought to cause more than 90 percent of all HPV-driven oropharyngeal cancers. The NHANES data showed that oral HPV 16 prevalence was very low on average in all groups, ranging from 0.1 percent in women ages 60 to 69 to 2.4 percent in men ages 60 to 69.
"Currently available tests for the presence of oral HPV infections are not very predictive of oropharyngeal cancer risk--most people who have an oral HPV infection will eventually clear it on their own," says study co-author Gypsyamber D'Souza, PhD, an associate professor at Johns Hopkins University.
Throat Cancer From HPV Is Uncommon
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