Busting Common STD Myths: HPV Can Be Transmitted Orally
written by: Kira Jaines
• edited by: Emma Lloyd
• updated: 7/7/2010
Can a kiss transmit HPV? What about oral sex? Studies conducted by researchers at Johns Hopkins University found that not only can human papillomavirus be transmitted orally, it can also increase the risk of oropharyngeal cancer.
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In a word, yes. Once thought to be uncommon, the oral transmission of human papilloma virus (HPV) through oral sex and even French kissing has been documented and linked to an increasing rate of oropharyngeal cancer. The oropharynx consists of the base the tongue, the tonsils, the back of the mouth and the walls of the throat. Results of a study by Johns Hopkins researchers published in the New England Journal of Medicine in 2007 linked HPV exposure and infection to an increased risk of cancer of the mouth and throat. HPV infection has rapidly caught up with tobacco and alcohol as a risk factor for oral cancer, and has, in fact, become one of the leading causes of oral cancer in men, independently of smoking and drinking.
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Over 120 different HPV viruses have been identified, according to the Oral Cancer Foundation. Different types of HPV infect different parts of the body. Some cause warts on the skin. Some cause warts on the genitals. Some are harmless. Some cause cancer. The HPV virus is easily passed via skin-to-skin contact or sexual contact. HPV viruses cause no early identifiable symptoms and most are fought off by the body’s immune system. In fact, sexually-active adults have a 75 percent chance of acquiring HPV during their lifetimes though they may never know they are infected and the infection often resolves without treatment--even infection with high-risk strains of HPV. But prolonged infection with a high-risk strain can develop into cancer. These are the sexually-transmitted strains that cause cervical, anal and penile cancers and are now known to cause oral cancer as well. Can HPV be transmitted orally? Absolutely.
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Oral Transmission of HPV
Open-mouthed kissing, or French kissing, can transmit the HPV virus, as can oral sex. Like cervical cancer, the oropharyngeal cancer associated with HPV infection is slow-growing and silent. It may take 10 to 20 years for an oral HPV infection to progress to cancer, according to Dr. Maura L. Gillison of Ohio State University, Columbus. Her 2009 study of both adult and college-aged men found that 4.8 percent of the adults and 2.9 percent of the college-aged men did have oral HPV infection. Among the adults, the odds of HPV infection were significantly greater in smokers and those who had more than 10 oral sex partners or more than 25 vaginal sex partners. In the college-aged men, the chance of oral HPV infection increased significantly with having at least six recent oral sex or open-mouthed kissing partners. Even for the 28 percent of college-aged men who had never performed oral sex, the risk of HPV infection was also significantly increased if they had at least 10 lifetime or five recent open-mouthed kissing partners.
Gillison’s study also found that oropharyngeal cancer linked to HPV can be distinguished from that linked to prolonged use of tobacco and alcohol, and the two types respond differently to treatment. Study participants whose oropharyngeal tumors tested HPV positive had a better chance of survival compared to patients whose tumors tested HPV negative.
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Vaccines like Gardasil and Cervarix are preventive but will not treat HPV infection. Both protect against the HPV type linked with cervical and oral cancer. In 2010, Cervarix is approved only for females, but Gardasil is approved for males ages 9 through 26 and females ages 13 through 26. In addition to vaccination, limiting the number of sexual partners and choosing partners with few or no prior partners will decrease the chance of contracting the HPV virus. Annual oral cancer screenings with a dentist can also detect early HPV changes that may otherwise go unnoticed for years.