Young people * Sexual health

Throat cancer sex link

HPV linked to head and neck cancers Boys may need to be vaccinated against HPV

A virus which can be spread by oral sex has been linked to the increasing number of cases of head and neck cancer worldwide.

Despite an overall reduction in the total number of head and neck cancer cases, there has been a rapid rise in a particular type of head and neck cancer that begins in the middle part of the throat, called oesophageal squamous cell carcinoma (OSCC).

In the UK alone, the number of men diagnosed with OSCC has risen by over 50% between 1989 and 2006.

Previous research has linked a human papillomavirus (HPV) to the development of OSCC.

In today's online British Medical Journal (BMJ), scientists from University Hospital Coventry suggest that sexual transmission of HPV might be behind the rise in OSCC cases, as the virus is being detected in increasing numbers of tissue samples taken from tumours.

A recent study found that the risk of developing oropharyngeal carcinoma was associated with a history of six or more lifetime sexual partners, four or more lifetime oral sex partners, and - for men - an earlier age at first sexual intercourse.

In fact, HPV related OSCC seems to be a new and distinct form of the disease. The only glimmer of hope is that survival rates for this type of head and neck cancer may be better than from OSCC unrelated to the virus.

Writing in the BMJ, Dr Hisham Mehanna of the Institute of Head and Neck Studies warns that the recent rapid rise in new OSCC cases has important public health implications.

Past studies have rejected vaccinating boys against HPV on economic grounds, but that may have to be reconsidered.

"We need to look at the evidence again to re-evaluate the cost effectiveness of male children in light of this new and rapidly rising incidence," said Dr Mehanna.

As OSCC patients are typically younger and employed, and - because outcomes seem to be more favourable than for patients with non-HPV related carcinoma - they live longer. This means they will also need lengthy support from health, social, and other services, and require help in returning to work, he added.

This article was published on Fri 26 March 2010

Image © Alexander Raths -

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