General Articles

Increases in Throat and Mouth Cancers Linked to HPV Infection

Summarized with assistance from Shannon Ingram, SIECUS Program Research Intern

Source: Anil Chaturvedi et al., “Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States,” Journal of Clinical Oncology (October 2011).
The U.S. has experienced a noteworthy rise in the number of cancers of the throat and mouth over the past 25 years. A team of cancer researchers studied 271 cancerous tissue specimens from three different national registries to determine whether Human Papillomavirus (HPV) played a role in this rise.1 Until now, evidence has been lacking. The tissue samples had been obtained from patients over a 20-year period (1984-2004). The researchers also projected the future burden of oropharyngeal cancers through the year 2030, along with other head/neck and cervical cancers.
Key Findings:
·   The overall rise in throat and mouth cancers from 1984-2004 was strongly associated with HPV infection; by contrast, the incidence (i.e. rate of new cases) of such cancers caused by tobacco and alcohol use declined over the same time period.
·   HPV prevalence in throat/mouth tumors increased from 16.3% in the 1980s to 72.7% in the 2000s.
·   The increase in throat/mouth tumors caused by HPV “perhaps arises from increased oral sex and oral HPV exposure.”2
·   By 2020, the number of HPV-positive throat and mouth cancers in the U.S. is expected to surpass the number of cervical cancers.
·   People with oropharyngeal cancers associated with HPV infection have “substantially better survival” compared to those with similar cancers linked to tobacco and alcohol use.
Prevention of HPV infection is a key objective of any sexual health promotion program. The researchers have demonstrated a link between HPV and cancers of the throat and mouth. However, the researchers did not set out to demonstrate the cause of these HPV infections and further research is necessary to better understand the role that oral sex plays in the rise of HPV-positive oropharyngeal cancers in the U.S. Research is also needed to determine whether an HPV vaccination can protect against infection of the throat and mouth. Sexuality educators should include these findings in discussions of sexual health risks, while carefully explaining to learners that much remains unknown about oral sex and HPV transmission.
1  Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, Jiang B, Goodman MT, Sibug-Saber M, Cozen W, Liu L, Lynch CF, Wentzensen N, Jordan RC, Altekruse S, Anderson WF, Rosenberg PS, Gillison ML (2011). Human papillomavirus and rising oropharyngeal cancer incidence in the United States. Journal of Clinical Oncology JCO.2011.36.4596; published online on October 3, 2011. <>
2  Ibid., p.4.