Rise in mouth cancer may be due to sexually transmitted infection
A sharp rise in a type of mouth cancer may be due to a sexually transmitted infection that also causes cervical cancer, researchers have suggested.
By Rebecca Smith, Medical Editor, Daily Telegraph UK
Published: 7:25AM GMT 26 Mar 2010
There has been a 50 per cent rise in cases of a type of mouth cancer in the last twenty years and the increase appears to be in those linked to the human papilloma virus (HPV), the experts said. HPV also causes 80 per cent of cervical cancer cases and schoolgirls as young as 12 are currently being vaccinated against the virus in order to prevent the disease.
The authors of today's study, published in the British Medical Journal, said transmission of HPV through oral sex might be the reason for the increase in cases of mouth cancer. They said consideration should now be given to extending the HPV vaccination programme to boys. Lead author Hisham Mehanna, from the Institute of Head and Neck Studies and Education, University Hospital, Coventry, said HPV-related mouth cancer seemed to be a relatively new disease that was different from non-HPV related cancers in the mouth.
Mouth and throat cancers are normally associated with excessive smoking and drinking and they usually strike older people, killing around a third of sufferers within two years. However HPV-related cases have fairly good survival rate with around eight in ten still alive two years after diagnosis or higher depending on how advanced the cancer was when found.
There are around 1,000 cases of oropharyngeal cancer, which is a type of mouth cancer where the tumour is in the back of the mouth where it joins the throat.
The authors suggested sexual transmission of HPV through oral sex as a possible reason for the increase in those cases linked to the virus. They highlighted research showing that the risk of developing oropharyngeal cancer was increased by 25 per cent in those who had a history of six or more sexual partners. There had been a threefold increase in people with a history of four or more oral sex partners, they said.
An editorial accompanying the study in the British Medical Journal said: "There are also public health implications. Female only HPV vaccination programmes may affect the incidence of HPV related oropharyngeal carcinoma.
"A recent modelling study of the effects of HPV vaccination in males concluded that routinely vaccinating boys for HPV could not be justified on health economic grounds.
"The recent rapid rise in HPV related oropharyngeal carcinoma may alter the cost effectiveness of vaccinating boys before they become sexually active."
Nell Barrie, Cancer Research UK’s science information officer, said: “We know that HPV can cause oropharyngeal cancer, as well as several other types of cancer including cervical cancer.
"But although HPV infection is common, the virus causes cancer only in a minority of people. More research will be needed to determine if patients with HPV related head and neck cancer could benefit from different treatment, and to understand if any changes to health services are needed.
“It will also be interesting to see if the HPV vaccine could help to reduce rates of oropharyngeal cancer. The vaccine protects against cervical cancer by immunising women against the two most common cancer-causing types of HPV.”
