HPV: It's Not Just For Ladies Anymore

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By 2020, cases of throat cancer caused by the human papillomavirus may outnumber those of HPV-caused cervical cancer

Bad news on HPV:  it now seems to be the leading cause of throat cancer in men. Worse news: it may be spread by kissing.

Researchers examined 271 throat-tumor samples collected over 20 years ending in 2004 and found that the percentage of oral cancer linked to the human papillomavirus, or HPV, surged to 72 percent from about 16 percent, according to a report released yesterday in the Journal of Clinical Oncology. By 2020, the virus-linked throat tumors -- which mostly affected men -- will become more common than HPV-caused cervical cancer, the report found.

. . . Until recently, head and neck cancer mainly occurred in older patients and was associated with tobacco and alcohol use. The HPV-linked head and neck cancers, usually of the tonsils, palate or tongue, hit men their 30s, 40s, and 50s, Gillison said. It is unclear why women are affected much less often than men, she said.

. . . In a 2007 epidemiology study published in the New England Journal of Medicine, Gillison and her colleagues found that having a high number of oral or vaginal sex partners are risk factors for HPV-associated throat cancer. The cancer may also be spread by open-mouth kissing, Gillison said in the interview. "Nobody paid attention to oral HPV infections until 2007," she said. "We are about 15 years behind in the research" compared with the data on cervical cancer and HPV, she said.
The most troubling thing for me is that I imagine that this is going to be harder to detect than cervical cancer. (ENTs and cancer docs, please feel free to correct me).  As an OB-GYN said to me, "HPV just loves the cervix", which means that as long as you're getting regular pap smears, the doctor is very, very likely to catch a genital infection before it turns into terminal cancer.  (I don't mean to imply that the treatments are no big deal, because they aren't--they range from uncomfortable to excruciating and can mean infertility.  But they're still preferable to being dead.)

But the throat's got a lot of stuff in there, a lot of nooks and crannies where HPV could hide--can we catch potentially cancerous oral infections the way we do when they're in the reproductive tract?

The other question I have is whether this is going to change the terms of the debate around HPV vaccines.  Me, I figure if we can possibly wipe out a virus that gives people cancer, we should do our very damndest.  Regardless of how the cancer is contracted.  But from the extremely emotional response I got when I blogged about Gardasil a few weeks ago, this is obviously not the universal view.

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Megan McArdle is a columnist at Bloomberg View and a former senior editor at The Atlantic. Her new book is The Up Side of Down.

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