The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and according to the Centers for Disease Control and Prevention (CDC), approximately 20 million Americans currently are infected. There are more than 100 strains of HPV, and more than 40 of them are capable of infecting the mouth and throat. Ten years ago, 40 percent of oral cancer biopsies were HPV-positive; today, that figure is closer to an astounding 80 percent, according to an article published in the June 2010 issue of AGD Impact, the Academy of General Dentistry's (AGD) monthly newsmagazine.
"HPV is so common that at least half of sexually active males and females will contract it at some point in their lives," says Eric K. Curtis, DDS, MA, MAGD, author of the article. "In 90 percent of the cases, the body's immune system clears HPV within two years; however, while the majority of HPV infections do not lead to oral cancers, there's no escaping the fact that some of them do."
Oral cancer is typically hard to diagnose because it is not noticed by patients in its early stages. Warning signs include white or red lesions, soreness or feeling that something is caught in the throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, and numbness of the tongue or other areas of the mouth.
"While the incidence of oral cancers among Americans in general has decreased, probably due to reduced tobacco use, certain kinds of oral and oropharyngeal cancer have increased, especially in younger populations," says Dr. Curtis. "We are seeing more and more people who have never smoked or taken a drink in their lives and are astonished to learn that they've developed oral cancer from HPV."
HPV is primarily transferred by skin-to-skin contact. Risk factors involve the number of sexual partners (the more partners, the greater risk of infection) and age and gender (genital HPV infections are most commonly diagnosed in sexually active girls and women under the age of 25).
"It's imperative that all sexually active females see their general dentist to be screened for oral cancer on a regular basis," says Gigi Meinecke, DMD, FAGD, spokesperson for the AGD. "Remember, your OB-GYN doesn't look in your mouth to check for sexually transmitted diseases or oral cancer. Only your dentist is doing that for you."
In addition to an HPV-related infection, other risk factors for developing oral cancer include tobacco or alcohol use, age, gender (oral cancer strikes men twice as often as it does women), and race (oral cancer occurs more frequently in African Americans than it does in Caucasians). Oral cancer is the eighth most common cancer among men and the fourteenth most common cancer among women.
Although HPV's mode of transmission to the oral cavity is less understood and less defined at this time, researchers believe that changing behaviors in tobacco and alcohol use and sexual practices in the United States may indicate that specific mechanisms are responsible for the origination of cancers at particular locations in the body.
Reviewed: January 2012