We may seem more progressive today than we were fifty years ago, and we are in a lot of ways, but on some issues such as sex we are still old-fashioned at heart. Vital information about the human papillomavirus (HPV) and cervical cancer is probably missing from most sex education classes. In addition, kids surely haven't been told about the latest information about HPV. People young or old may have the false impression that oral sex is a relatively safe form of sex, but the truth is that in addition to familiar sexually transmitted diseases, it could be a risk factor for oral cancer.
A recent study published in the Journal of Clinical Oncology found that oral HPV infection is strongly associated with oropharyngeal (mouth and throat) cancer among subjects with or without the established risk factors of tobacco or alcohol use. This is an interesting revelation, since the two main factors that account for 80% of oral cancer are smoking and alcohol use. We may have identified a third risk factor, HPV infection. Oral cancers that are possibly HPV-related increased in the United States from 1973 to 2004, possibly as a result of changing sexual behaviors. The study also found that the increase in incident cases has been observed particularly among young white men. Another study in the New England Journal of Medicine in May 2007 found that a high lifetime number of sex partners -- including intercourse or oral sex -- was associated with the presence of oropharyngeal cancer, and the degree of association increased with an increasing number of partners.
The first line of defense against the spread of HPV should be education. If we are not properly educating people (especially youngsters) about safe sex and the risks associated with oral sex, we could continue to see a rise in oral cancer that may be HPV-related. Without proper sex education given at school or at home, we are leaving young people to the whims of their hormones and peer pressure.
The second line of defense against HPV could be to vaccinate girls and boys at age eleven or twelve before they become sexually active. Although there have been no studies yet investigating whether the vaccine can also protect against throat cancer, there are clearly potential benefits from the vaccine for boys as well. Just a few weeks ago, an article appeared in the New York Times about vaccinating boys for girls' sake. Although the title makes boys seem altruistic, they would also be protecting themselves against genital warts and possibly other rare HPV-related cancers such as anal and penile cancers. Currently, in the U.S., Gardasil is approved only for girls (in the European Union it was approved for both sexes), but by 2009 it could be approved for boys as well. The vaccine protects against four types of HPV, two of which have been found in 70% of cervical cancer cases and two of which account for 90% of genital warts, which affect both men and women. Some skeptics may label HPV a "girl's problem," but it is becoming more evident that HPV is everyone's problem.
While it's disappointing to discover that HPV may cause oral cancer, there are some simple steps that can be taken to lessen the risk, such as educating about condom usage and vaccinating both boys and girls against HPV. We shouldn't allow our feelings about sex to interfere with the health of our loved ones, by denying them vaccines or proper sex education for fear of rampant promiscuity. If we found vaccines to help protect against breast cancer or prostate cancer, would we not take advantage of them? We should recognize the benefits of the HPV vaccine in helping protect against cervical cancer and possibly oral cancer.
Krystal Ford is a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
