As if we didn’t already have enough to worry about: HPV has been linked to risk for oral cancer. HPV – human papilloma virus – is spread through skin-to-skin contact, including oral sex.
HPV is very common. It is the virus that causes anal and genital warts. Estimates are that 50% of sexually active men and women in the US carry the virus. A 1998 study of gay men in San Francisco found that 61% of HIV negative men and 93% of HIV positive men tested positive for the HPV virus.
There are many strains of the virus – 40 or more — 2 of which have been associated with cervical cancer and anal cancer. In most cases, the body naturally clears the virus within 2 years without the person involved having any symptoms. When the body doesn’t clear the virus, these two virus strains can cause cell changes that may be precancerous can develop.
Anal cancer has been a growing concern among many health care professionals treating gay men. HPV’s association with oral cancer has more recently come to light. The Oral Cancer Foundation reports:
- Tobacco use, for years the identified source of most oral cancers, has been declining, but the rate of oral cancer has been stable or slightly increasing.
- 60% of oral cancer patients are HPV positive. (Compared to 50% of the general population.)
- HPV is thought to be the causative agent in 25-75% of oral cancers. (There hasn’t been systematic screening for HPV, so data is far from precise.)
It’s that last item that is of concern to sexually active men and women.
The Oral Cancer Foundation recommends annual screening for people who have oral sex. Many dentists routinely screen for oral cancer. The foundation recommends having your physician screen your neck and lymph nodes for any abnormalities. Early detection leads to better outcomes.
Talk to your doctor about HPV vaccination. Gardasil is an effective vaccine against HPV, and is thought to be an effective safeguard against cervical cancer, anal cancer and oral cancer. The vaccine is currently authorized only for those under 26. That means that if you’re older your insurance is unlikely to pay for it. The cost is about $450 – not cheap, but less expensive than treatment for warts or cancer.
There is no reason to panic. Obviously, most people who enjoy oral sex do not develop oral cancer. I remember a sex educator saying once that if HIV were easily transmitted by oral sex, all gay men would have HIV. But although oral sex can transmit HIV, that doesn’t happen easily; most gay men do not have HIV. Most gay men who enjoy oral sex will not develop oral cancer. It’s a matter of educating and taking care of yourself. More information about HPV is available from the CDC. Talk to your dentist and your physician. And be aware that many physicians don’t seem especially up to date or aggressive in talking about HPV with their patients, so you should be prepared to take the initiative in having this conversation.