Oral sex raises risk of getting cancer by 22%

A new study, published in the journal JAMA Oncology, suggests that oral sex dramatically increases the risk of head and neck cancers. The disease has traditionally been considered to be one that affects smokers and heavy drinkers in later life. But over recent years, as cases have been rising, it has been linked with the common human papillomavirus (HPV).It is believed oral sex may be the main way HPV – more usually associated with cervical cancer – ends up in the mouth.

The HPV is the name given to a group of viruses that affect a person’s skin as well as the membranes lining the body – for example, in the cervix, anus, mouth and throat. HPV is very common and highly contagious. More than three quarters of sexually active women acquiring it at some point in their lives.HPV-16 is a well-known cause of oropharyngeal tumours – those, which affect the middle part of the throat including the soft palate, the base of the tongue and the tonsils.

While HPV does not directly trigger cancer, it causes changes in the cells it has infected (for example, in the throat or cervix), and these cells can then become cancerous. Men are twice as likely to get oropharyngeal cancer as women, according to NHS choices, because performing cunnilingus is more risky than fellatio. It is the 11th most common cancer worldwide, according to World Health Organisation figures.Worldwide almost half-a-million patients a year will be diagnosed with oral and oropharyngeal cancer. More than two thirds of cases are diagnosed in advanced stages where the cancer has already spread to regional lymph nodes or beyond, the global oral cancer forum reports.

Approximately 150,000 patients die each year and many more suffer from the complications of treatment.While girls aged 12 to 13 are offered a vaccination to help protect them against types of HPV that can cause cervical cancer, there is no immunisation programme for boys. An official recommendation on whether to offer the HPV vaccine to all adolescent boys is expected in early 2017.This new study, published in the journal JAMA Oncology, is the first to show conclusively that HPV-16’s presence in the mouth leads to the development of oropharyngeal cancer. This follows a study in The New England Journal of Medicine which showed that those infected with HPV were 32 times more likely to develop oral or throat cancers.

WHY MEN ARE MOST LIKELY TO GET OROPHARYNGEAL CANCER?

Oropharyngeal cancer is twice as common in men than in women, according to National Health Scheme (NHS) Choices.It is most common in heterosexual men in their 40s and 50s (compared to the rates in homosexual men). This indicates that performing cunnilingus (oral sex on a woman) is more risky that performing fellatio (oral sex on a man). The concentration of HPV in the thinner, moist skin of the vulva is much higher than the amounts of virus shed from the thicker, dry skin of the penis, and this affects how easy it is to pass the virus on.Other research indicates that HPV can be present in semen and passed on at ejaculation. And previous research published in the Journal of Clinical Oncology found HPV now accounts for more head and neck cancers than tobacco or alcohol. Spread by skin-to-skin contact, not just by sex, HPV affects almost everyone at some stage in their life.In most people, the immune system fights it off and it does no harm.But on rare occasions, the virus takes hold, leading to a chain of events that ends in cancer of the cervix, penis, anus, vagina or mouth. Around 15 strains can cause cervical cancer – and HPV-16 is the most common.The most dangerous HPV’s, 16 and 18, which are transmitted through sexual contact are known to cause up to 95 per cent of cervical cancers. Now these two HPV’s are also being linked to oral cancer.

A different study done by Dr. No-Hee Park, a leading expert in head and neck cancers at University of California Los Angeles (UCLA), United States (U.S.), showed that the mouth was, at the cellular level, structurally very similar to the vagina and cervix. Both organs have the same type of epithelial cells that are the target of HPV 16 and HPV 18. The majority of oral cancers are cancers of epithelial cells, primarily squamous cell carcinomas, not unlike the cancers that affect the cervix. Park’s study also showed that smoking and drinking alcohol help promote HPV invasion.Combine tobacco and alcohol with HPV, and the epithelial cells in the mouth, and you may have the formula for the development of an oral cancer. The new research, carried out at Albert Einstein College of Medicine in New York, suggested people carrying the virus in their mouth were an alarming 22 times more likely to develop a potentially lethal tumour.The finding was based on almost 97,000 people who provided mouthwash samples and were cancer-free at the beginning of the project.

WHAT ARE THE SYMPTOMS OF ORAL CANCER?

Mouth ulcers, which do not heal within three weeks Red or white patches in the mouth A lump or thickening on the lip A lump in the mouth or throat Unusual bleeding or numbness in the mouth Loose teeth for no apparent reason Difficulty moving the jaw Difficulty in swallowing Speech problems A lump in the neck. Be aware that a hot, red, painful lump usually means an infection, rather than a cancer. Lumps that come and go are not usually due to cancer either. Cancer usually forms a lump that slowly gets bigger. Dr. Nigel Carter, chief executive of the British Dental Health Foundation, added: “Your dentist will check for signs of mouth cancer during your regular check-up so it’s important to attend regularly to catch any signs you may miss yourself.” They were followed for an average of four years, during which time a total of 132 cases of head and neck cancer were identified.The study participants were compared with 396 healthy people who acted as controls. Mouthwash samples were analysed for the presence of several types of oral human papillomavirus (HPVs) in both groups. These revealed people with HPV-16 in their mouthwash were 22 times more likely to develop oropharyngeal cancer (oropharynx is the part of the throat directly behind the mouth) than were those with no detectable trace of the virus HPV-16 in their samples. In addition, the researchers found for the first time that the presence of other types of oral HPVs, known as beta and gamma, which are usually detected in the skin, were also associated with the development of head and neck cancers.

*Adapted from DailyMailUK online
From:TheGuard