Throat and mouth cancers, broadly known as oropharyngeal cancers, linked to HPV are on the rise, mostly in middle-aged and older men, data suggests. These cancers affect the back of the throat along the tonsils and the base of the tongue. A 2023 study of the U.S. found that cases of HPV-related oropharyngeal cancer had more than tripled between 1988 and 2004, with the bulk of that trend driven by male patients. This trend continues worldwide today, with one Danish study finding another tripling between 2000 and 2017.
HPV is an umbrella term that includes many viruses; those that cause cancer are known as "high-risk HPV." These high-risk strains spread during sex, including oral sex, making the leap from one body to another through tiny cuts in the skin or mucous membranes.
There are 12 types of high-risk HPV, which are known to cause anal cancer, cervical cancer, oropharyngeal cancer, penile cancer, vaginal cancer and vulvar cancer. Two strains, known as types 16 and 18, are the most likely to cause cancer.
Why are throat and mouth cancers on the rise?
According to data from the U.S. Centers for Disease Control and Prevention, an average of 13,600 cases of oropharyngeal cancers likely caused by HPV are diagnosed in men each year. By contrast, there are 2,400 newly diagnosed cases in women per year. The number of cervical cancer cases likely caused by HPV each year is currently around 11,100.
The adoption of HPV vaccination among both male and female patients should lead to an eventual decline in oropharyngeal cancers, as it has in cervical cancer. But because HPV can lurk in the body and wreak havoc long after a person is initially exposed, risks for older individuals who were not vaccinated as young people still persist.
HPV-related throat and mouth cancers are challenging to screen for, so often, people don't get diagnosed until after symptoms start to emerge. (Image credit: vitapix via Getty Images)
As people with chronic HPV infections age, the immune system may do a poor job of keeping the virus in check, said Electra Paskett, a cancer epidemiologist at The Ohio State University College of Medicine. Other factors, such as chronic stress, may also play a role in the immune system losing grip on the germ. That's likely why a virus contracted decades ago can cause cancer in middle-aged or older people.
One study of patients in Baltimore found that men were more likely than women to have oral HPV infections, with their degree of risk tied to their number of recent oral and vaginal sex partners. Performing oral sex was linked to oral HPV infection in men in the study but not women. In addition, men were slower to clear these HPV infections than women, perhaps indicating immune system differences that make men more prone to chronic HPV of the throat and mouth.
Are there ways to screen for HPV oropharyngeal cancers?
For example, Pap smears detect precancerous cells in the cervix, allowing doctors to remove them before they turn fully cancerous, and HPV tests look directly for the virus's genetic material. But it's not possible to take swabs or biopsies of the back of the throat without causing serious discomfort and damage, Harper told Live Science.
However, the treatment is "grueling," Paskett said, with side effects from radiation including mouth sores, nausea, loss of appetite and weight loss.
HPV vaccination is mostly thought of as preventing cervical cancer, but it should also drive down rates of other HPV-related cancers in the long run. (Image credit: Anchiy via Getty Images)Should more men get vaccinated?
However, Harper said, patients ages 26 to 45 who haven't been vaccinated yet should talk to their doctors about their sexual history and current sexual activity to decide if the shot might benefit them.
Say a person has had few sexual partners and is expected to be monogamous for life, but they suddenly find themselves divorced or widowed after age 46. That person might consider getting the HPV vaccine series before reentering the dating pool, Harper suggested.
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"For parents, I beg — I beg [you] to please consider vaccinating both your girls and your boys," she said. "If you do it at the age of 15 or younger, they only need one shot," she added. Recent clinical trials show that one dose of the vaccine, if delivered before the age of 16, is as effective as two. That said, official recommendations still suggest that patients get two doses of the vaccine if they start the series before age 15, and potentially three doses if they start later.
This article is for informational purposes only and is not meant to offer medical advice.
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