Other HPV Diseases

Oral Sex, HPV, and Throat Cancer

I’ve been reading about Michael Douglas and his comments that his oral cancer was caused by HPV. I’ve given my girlfriend oral sex and she was diagnosed with HPV, so is this something I need to worry about?

It is possible to contract HPV by performing oral sex on a partner with HPV (although the overall risk is lower than with genital-to-genital contact or anal sex). HPV-related cancers are relatively rare, however, especially when you consider just how common HPV is. The vast majority (some estimates peg it at 75% or more) of sexually active people have one or more HPV infections in their lifetimes. We also know that oral sex is a routine practice, an experience that most sexually active individuals are likely to have. So lots of HPV, lots of oral sex….but very, very few head and neck cancers.

HPV-related head and neck cancers tend to affect the oropharynx (mostly the back of the tongue, tonsils, and side and back of the throat). Data from the National Cancer Institute tell us there are about 13,000 oropharyngeal cancers each year in the U.S., 60%-70% of which appear to be caused by one HPV type, HPV 16. As is the case with cervical cancer, oropharyngeal tumors caught early are highly treatable and those caused by HPV have a high survival rate.

This is an emerging area of interest and study, and in the years to come we’ll surely know more about oral HPV infections, the routes of transmission, and related diseases. It’s important to keep the risk in perspective: head and neck cancers are not common in general, only one type seems linked to HPV, and most oral HPV infections do not lead to cancer.

>For more on head and neck cancer with the American Cancer Society. Learn about HPV in ASHA’s HPV Resource Center.

Vaginal and Vulvar Cancers

My mother was diagnosed with vaginal precancer and we’ve never heard of anything like that. Is it related to HPV and how do you know if you have it?

High-risk HPV types have been linked with some, but not all, cases of vaginal intraepithelial neoplasia (VaIN) and vaginal cancers (60% or so is the estimate). Like cancer of the cervix, vaginal cancer does not happen overnight; it is typically a slow-growing condition that develops from pre-cancerous changes in the vagina. Women diagnosed with severe cervical precancers or with cervical cancer will typically be checked for additional lesions inside the vagina with a colposcopy (a health care professional uses a special microscope to examine the area). A biopsy may also be taken of suspicious looking areas to confirm the diagnosis. Since mild, or low-grade, VaIN often disappears without any treatement, many providers will opt only to treat high-grade or persistent lesions. When treatment is elected, the most common options include surgical removal and laser for significant lesions.

High-risk HPV types have also been associated with some cases of pre-cancerous cell changes on the vulva (the lips of the vaginal opening) and with about 30-40% of vulvar cancers. The most common symptom of Vulvar Intraepithelial Neoplasia (VIN) is persistent itching that does not improve. Having pelvic exams on a regular basis and being alert for any unusual skin discoloration or bumps that last longer than a month greatly improves the chances of early detection. Various treatment options are available, depending on how mild or severe the cell changes are, the size of the lesion(s), patient's age, and potential for cancer to develop.

--The NCCC Staff