The incidence of HPV throat cancer, also called oropharyngeal cancer, has been increasing significantly in the US. It is caused by HPV, or human papillomavirus, which is a type of virus that spreads by sexual transmission, during genital, anal, and oral sex. Although HPV infection is fairly common, cancer caused by the virus is less common, and has been associated more with cervical cancer. However, in 2010, it has been estimated by the National Cancer Institute that there were more than 12,000 cases of throat cancer in the US, and about three-fourths of these cases were caused by HPV. Researchers have analyzed data and estimate that if the rise in HPV throat cancer continues, there will be more of these cases than cervical cancer cases by 2020.
HPV throat cancer affects the oropharynx, which includes the area at the back of the mouth, including the base of the tongue, soft palate (roof of the mouth), the tonsils, and the sides and back wall of the throat.
Risk Factors
There are more than 40 types of HPVs than can be sexually transmitted, but HPV types 16 and 18 have been determined to be the cause of about 70% of cervical cancers, while HPV-16 is responsible for more than half of the cases of throat cancers.
Men are primarily affected. Researchers also attribute the rising trend to increased practice of oral sex, especially among younger individuals who consider it is safer than sexual intercourse. Furthermore, having six or more oral sex partners can increase the risk for the disease by eightfold. A previous history of HPV oral infection is also associated with increased likelihood of developing the cancer.
Poor oral hygiene, smoking, heavy alcohol use, chronic inflammation, and a compromised or weak immune system may also increase the risk for HPV throat cancer.
Symptoms
Symptoms of HPV throat cancer are similar to other types of throat cancer. These include:
- A painless lump in the throat that persists
- A sore in the throat that does not heal
- Unexplained bleeding or pain in the throat
- Difficulty in chewing or swallowing
- A persistent change in voice
- Swollen neck nodes
- Persistent ear pain
These symptoms may be similar to a throat infection or trauma. However, if they are related to throat cancer they will extend beyond 2 to 4 weeks and will not improve with antibiotics or pain medications. They will progressively worsen. You should therefore consult a doctor if you experience these symptoms.
Prevention
Not all HPV infections will develop into cancer. However, persistent infection with HPV type 16 or 18 can lead to cancer. To prevent infection, you must avoid skin-to-skin vaginal, oral, or anal contact with an infected person. The use of a condom is not a guarantee against infection. It is also recommended that sexually active individuals have a long-term, monogamous relationship with an uninfected person.
There are FDA approved HPV vaccines (Gardasil? and Cervarix?) available to prevent cervical, vaginal, and anal cancer, as well as genital warts. These are effective in preventing infections with HPV 16 and 18. However, they have not been approved for throat cancer or penile cancer. Nevertheless, HPV vaccination has been approved for males to protect against genital warts and anal cancer.
There are no screening tests for HPV cancer of the throat.
Treatment
Fortunately, HPV throat cancers respond to treatment more easily than other forms of throat cancers. Depending on the stage of the disease, treatment may include surgery, chemotherapy, radiation therapy, or a combination. Research has shown that the disease responds well to radiotherapy, especially in non-smokers.