The sexually transmitted virus that causes cervical cancer in women has now been linked to an uptick of throat, tonsil and tongue cancers - in a younger and healthier group of patients than doctors have ever seen before.
These head and neck cancers were once the scourge of older men - mostly the result of lifetimes of heavy smoking and drinking. The treatments often left victims disfigured.
But with those cases on the decline, doctors are seeing a new group of victims. They're men in their 40s, and even 30s, whose cancer is brought on by the increasingly common human papillomavirus (HPV). It's an infection that more than half of Americans will encounter during their lifetimes. And researchers now believe that the increase in certain oral cancers can be traced to the spread of the virus through oral sex.
New studies suggest that HPV-related oral cancer cases are on pace to eventually surpass cases of cervical cancer in the United States, which strikes about 11,000 women each year. And many doctors do not realize that they should be on the lookout for oral cancer in younger patients.
"It just kind of rocks the whole paradigm," said Dr. Maura Gillison, a Johns Hopkins oncologist who is credited with making the link between HPV and oral cancers. "Everyone thinks of the long-term smoker, the long-term drinker. Now we're seeing the movers and shakers in the prime of life."
Gillison and others say they hope an HPV vaccine designed to protect girls and young women against cervical cancer will be approved for boys and tested for head and neck cancers, which are more likely to affect men than women.
Researchers say changing sexual behavior probably accounts for the explosion of HPV-related oral cancers. In a study published last year in The New England Journal of Medicine, Gillison and colleagues found the strongest link in patients with larger numbers of lifetime sex partners.
The sexual revolution of the 1960s made it more acceptable to have more sex partners, she and others said. And, if the AIDS scare of the 1980s persuaded many to have safer sex, the caution didn't always extend to oral sex. The bottom line: more HPV-related oral cancers.
A reluctance to discuss oral sex may be why the public knows so little about the link between HPV and head and neck cancers.
There is plenty of open talk about preventing cervical cancer nowadays, including commercials that tout the blockbuster HPV vaccine with girls chanting about becoming "One Less." But there's still more of a taboo when it comes to talking about oral sex.
