HPV and Oral Health

***UPDATED: April 16, 2015*** While the HPV vaccine, administered to pre-teen girls and boys, has raised some controversy since its creation, a new study finds it has even more benefits than expected. According to a recent U.S. News article, about 9,300 men in the United States are affected annually by HPV-related cancers, including oropharyngeal, that occurs in the middle part of the throat. It is estimated that by 2020, HPV-related oropharyngeal cancer will be the most common in the U.S. The study, which was just released online on Monday, indicates that vaccinating 12-year-old boys against HPV is a cost-effective strategy for preventing throat cancer.  For women, the vaccines Gardasil and Cervarix have been shown to protect against 70% of cervical cancers and 90% of genital warts cases. Both vaccines work in the body for a minimum of 10 years without a decrease in effectiveness and neither have been associated with any long-term health problems. HPV is the most common sexually transmitted disease in the United States, infecting 14 million people each year. There are over 100 strains, 30 of which can put women at risk for cervical, vulvar or vaginal cancer. Those infected can spread the virus, even if they haven’t shown any symptoms, and it can take years for cancer to develop. For men, throat cancer typically develops between the ages of 40 and 60, and a test can determine whether HPV is the cause. Recent research has linked approximately 70-80% of incidences of throat cancer to HPV.

***UPDATED: November 29, 2013*** Oropharyngeal cancer has been on the rise around the globe and a new study has found that the increase in this type of cancer is especially prevalent in economically developed countries.  Researchers from the U.S. evaluated trends for oropharyngeal cancer and oral cancer in 23 countries, utilizing a cancer registry of more than 180,000 patients worldwide.  Among the findings was the realization that women in particular saw an increase in oropharyngeal cancer and both oral cancer and lung cancer, two conditions strongly associated with smoking.  Among men, the number of oropharyngeal cancer incidents increased despite a decrease in oral cavity cancers.  This led scientists to suggest that other factors, such as HPV infection, could have contributed to an overall increase in oropharyngeal cancer cases worldwide.

The relationship between oral cancer and human papillomavirus (HPV) made international headlines in June when actor Michael Douglas implied that his throat cancer was not caused by tobacco and alcohol use as assumed, but rather through sexual contact.  The celebrity later released a statement that his claim was a misunderstanding, but scientists say that HPV could actually effect malignant growths in the throat, predominantly through oral sex.  According to a recent Time magazine news article, the Centers for Disease Control (CDC) has reported that approximately 60% of oropharyngeal cancers (throat, tonsils, and tongue) are related to HPV.  Additionally, a new study published in the journal Cancer Prevention Research has concluded that poor oral health, including dental problems and gum disease, is in fact an independent risk factor for oral HPV infection, meaning it could also contribute to oral cancers.

The study was completed by a research team from the University of Texas Health Sciences Center and included more than 3,400 participants aged 30-69.  Volunteers took part of in the 2009-2010 National Health and Nutrition Survey (NHANES), providing information on their oral health and HPV-infection status.  From that data, researchers learned that those who reported poor oral health had a 56% higher rate of HPV infection than those claiming to have healthy mouths.  According to Dr. Maura Gillison, a professor at the Ohio State University, the connection between the virus and oral cancers is relatively new, emerging approximately five years ago.  More than 2,370 new cases of HPV-related oropharyngeal cancers are diagnosed in women annually, while about 9,356 cases are diagnosed in men.  Gillison reported that the number of incidences for classical head and neck cancer caused by smoking has actually decreased, thanks to improved public-health awareness.  However, the overall rate of oropharynx cancer is still going up due to the HPV component.

When left untreated, HPV can cause cancers in the cervix, anus, penis, vulva, vagina, as well as in the head and neck.  Fortunately, two vaccines have been produced to protect against the most common forms of HPV, although they have been seen as controversial in recent years.  There is significant political and social resistance to the vaccinations, considering they are meant to be administered to young pre-teens.  Parents and politicians alike have publicly condemned them for fear they would promote promiscuity among pre-adolescents.  Additionally, few reports have suggested extreme side effects, such as fainting and increased chance of developing mental disorders.  Both have been proved to be unfounded as studies verified the safety of the vaccine and found no increase in sexual activity among those vaccinated.  Even without the vaccination, researchers have found that HPV in the head and neck can be controlled by practicing good oral hygiene.  Study author, Thanh Cong Bui, claims that by brushing regularly and keeping the mouth environment clean, HPV infection and subsequent HPV-related cancers can be prevented.

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