International Oral Cancer Association » HPV

Sex and Oral Cancer: What Is the Connection?

admin — Wed, 02 May 2012 14:00:18 +0000

Apr 4, 2012

By Jo-Anne Jones, RDH, President, RDH Connection Inc., CEO, Dental Hygiene Studios Inc.

Are sexual relations closely intertwined with oral health? It would appear so with the connection between the human papillomavirus (HPV) and oral cancer emerging as a global pandemic. Here are the latest and startling statistics that have emerged:

Currently HPV is the fastest growing sexually transmitted infection
At least 50% of sexually active men and women will acquire a genital human papillomavirus (HPV) infection at some point in their lives (1)
Most people who become infected with HPV do not even know they have it (1)
HPV DNA has been detected in 25% of head and neck squamous cell carcinomas overall, but especially in oral squamous cell carcinomas, for which 45-100% of cases were HPV positive (2,3,4)
The human papillomavirus has accounted for a 225% increase in oropharyngeal cancers from 1988-2004 (5)

The same viral strain, HPV-16 that is responsible for 70-80% of all cervical cancers, is solely responsible for 85-95% of all HPV related oropharyngeal cancers.(6) If recent incidence trends continue, the annual number of oropharyngeal cancers related to HPV-positive oropharyngeal cancers will surpass annual number of cervical cancers by the year 2020.(7) Among the sites of HPV-associated cancers, the oropharynx is the second most common after the cervix at present.

Oral Sex, Safer Sex?

Why the alarming increase? The conjecture is that this sharp increase is the “legacy” of the sexual revolution.

HPV is passed on through genital contact during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms. It has also been reported that HPV may be passed on through open-mouthed kissing if the virus is active.

A study which appeared in the New England Journal of Medicine shows that men and women who reported having six or more oral-sex partners during their lifetime had a nearly nine-fold increased risk of developing cancer of the tonsils or at the base of the tongue. Those with 1-5 oral sex partners are 2x more likely to contract HPV than those who have never had oral sex.(8) This is once again a testimony to the fact that oral sex is not safer sex.

What can we do as Oral Health Professionals?

With HPV-positive oropharyngeal cancer often occurring in areas where visual acuity is somewhat restricted, it is imperative to inspect the posterior areas of the mouth to the best of our abilities. HPV-positive oropharyngeal cancer has expressed an affinity for posterior regions of the oral cavity including the base of the tongue, the oropharynx, tonsils and the tonsillar pillars. Full protrusion of the tongue is critical in order to examine the posterior lateral borders and the dorsum. Both visual and tactile examination need to be performed in order to discover the earliest presence of an abnormal lesion. (Refer to Figures 1 and 2).

Figure 1: HP induced papillary lesion on left lateral border of tongue (image courtesy of Dr. Samson Ng, LED Dental)

Figure 2 provided with permission granted from the Canadian Dental Hygienists Association. The images originally appeared in the online course, “4 Life Saving Minutes: The Extraoral and Intraoral Examination” www.cdha.ca/oralcancer

There are also some subtle warning signs that accompany this virally and sexually transmitted oral cancer. Identifying some of the more subtle symptoms may allow our professional to identify posterior oropharyngeal abnormalities at a much earlier stage.

The following are signs and symptoms to be aware of in the assessment of the dental patient:

Hoarseness
Continuous sore throat or a throat infection not responding to antibiotics
Pain when swallowing or difficulty swallowing
Pain when chewing
Continual lymphadenopathy
Non-healing oral lesions
Bleeding in the mouth or throat
Ear pain
A lump in the throat or the feeling that something is stuck in the throat

Our profession of dental hygiene is strategically positioned to play an integral role in earlier discovery of an abnormal lesion thus contributing strongly to better treatment outcomes, improved survival rates and enhanced quality of life for our dental hygiene clients.

No one said it better than John F. Kennedy, “There are costs and risks to a program of action, but they are far less than the long-range risks and costs of comfortable inaction.”

We truly can make a difference.

Acknowledgements

Figure 1: HPV induced papillary lesion on left lateral border of tongue (image courtesy of Dr. Samson Ng, LED Dental)

References

1. Centres for Disease Control and Prevention: Genital HPV Infection – Fact Sheet. www.cdc.gov/std/HPV/STDFact-HPV.htm (Accessed Feb 2012).

2. Gillison ML, Koch WM, Capone RB et al. Evidence for a causal association between human papillomavirus and a subset of head and Neck cancers. J Natl Cancer Inst. 2000;92:709-20.

3. Ang KK, Harris J, Wheeler R, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Eng J Med. 2010;363:24-35.

4. Marur S, D’Souza G, Westra WH, et al. HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol. 2010;11:781-9.

5. Chaturvedi A, Engels A, Pfeiffer RM et al. Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States. Jour of Clin Oncol published on October 3, 2011.

6. Dayyani F, Etzel CJ, Liu M et al. Meta analysis of the impact of human papillomavirus(HPV) on cancer risk and overall survival in head and neck squamous cell carcinomas (HNSCC). Head Neck Oncol 2010; 2:15.

7. Cleveland JL, Junger ML, Saraiya M et al. The connection between human papillomavirus and oropharyngeal squamous cell carcinomas in the United States. Implications for Dentistry. JADA 142(8):2011;915-924

8. D’Souza G, Kreimer AR, Viscidi R, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007 May 10:356(19):1944-56.

Jo-Anne Jones is an international speaker and the President of RDH CONNECTION Inc., and CEO of Dental Hygiene Studios Inc. Jo-Anne may be contacted through info@rdhconnection.com.

New HPV Salivary Test to Detect Oral Cancer

admin — Mon, 08 Mar 2010 22:11:39 +0000

One of our goals here at The Fight Oral Cancer Foundation is to stay informed on new research and developments as they relate to oral cancer. Recently OralDNA Labs introduced a new test that will help dentists diagnose particular forms of oral cancer.

Shockingly, recent results have show that 50% of oral cancer cases are the resultant of HPV virus. This is a huge percentage, which is a leading factor in OralDNA Labs’ interest in finding a better way to diagnose and detect HPV in at-risk patients. According to OralDNA Labs, at-risk includes:

Sexually active

Family history of oral cancer

Signs and symptoms of oral cancer

Traditional risk factors for oral cancer

Suspicious oral lesions

Chief Dental Officer, Thomas W. Nabors, DDC offers this information regarding the effectiveness of the detection tool:

“Oral HPV is a silent, serious infection that can now be detected adn closely monitored by the dental professional. Specifically, the laboratory report derived from the OraRisk HPV salivary diagnostic test helps dental professionals identify the specific types(s) of HPV present, as well as the associated risk profile for each type of HPV variant detected in the patient’s oral cavity.”

Having these types of salivary test should be a part of every patient’s plan as together we all fight oral cancer.

“Together we fight oral cancer. Together we save a life every hour.“

***

Full Press Release

KXAS NBC 5 News Covers Oral Cancer and HPV

admin — Sun, 24 Jan 2010 17:39:20 +0000

Recently, KXAS-TV NBC Channel 5 did a segment on oral cancer and its strong link to HPV. Take a look at the below video for more information on this link and what professionals are saying.

UPDATE: This segment has been picked up by over 91 stations and received by over 2.5 million people

Oral Cancer: Too Deadly to Ignore

admin — Tue, 13 Oct 2009 19:43:33 +0000

According to CDC, Center for Disease Control and Prevention, survival rates for patients with oral cancer are among the lowest of major cancers. Only one-half the number of persons diagnosed with oral cancer are alive five years after the diagnosis. In contrast to other cancers (e.g. breast, colorectal, and prostate cancers) the overall U.S. survival rate from oral and pharyngeal cancer has not improved during the past 16 years. Survival rates for oral cancer in minorities have decreased. To read more visit the Center for Disease Control and Prevention website.

Look for signs of oral cancer and do not ignore them or you have ignored your own life.

“Together we fight oral cancer. Together we save a life every hour.” – The Fight Oral Cancer Foundation

HPV, Other Risk Factors Tied to Oral Cancer: New Web Site Offers Awareness, Early Detection Information

admin — Fri, 02 Oct 2009 16:11:28 +0000

The Fight Oral Cancer Foundation (FOCF) has launched website to increase public awareness of oral cancer.

According to The Fight Oral Cancer Foundation (FOCF), oral cancer is one of the most deadly cancers, with the latest medical research linking it to the Human Papillomavirus (HPV). Other risk factors include alcohol and tobacco use, male gender, 40-plus years of age and sun exposure. Many studies report a 30-fold increased risk among individuals who smoke or drink heavily.

With 35,000 new cases diagnosed in the United States each year, only 59 percent are expected to survive longer than 5 years.

Included in the staggering amount of people affected by oral cancer are well-known celebrities such as Rod Stewart, Aaron Spelling, Diane Von Furstenburg and Peter Tork, drummer for the 1960s hit band, The Monkees.

Despite the deadly nature of this disease, the American public remains generally unaware of the risk factors and the critical importance of early detection.

“Today, one person, every hour of every day dies from oral cancer,” says Arma Shahidi-Fitzgerald, FOCF founder and president. Fitzgerald explains that awareness, research and funding are the keys to increasing survival rates.

Fitzgerald, who was crowned Mrs. International 2009 earlier this month, was inspired to launch the foundation after losing a dear friend to the disease.

“She was diagnosed too late to be treated,” Fitzgerald explains. “What made this loss more painful was that early detection could have saved her life.”

As a result, Fitzgerald is centering her life’s work on oral cancer prevention and education. Fitzgerald believes the new web site is a “step on a lifelong journey.”

Fitzgerald has also begun speaking at public events and is working on relationship-building with the American Cancer Society and other cancer awareness and support organizations.

In addition to learning more about the foundation and disease, the Web site also allows viewers to donate to the foundation, offers suggestions on how to get involved with the cause and includes an interactive blog with the latest news on oral cancer.

HPV Linked to Oral Cancer

admin — Thu, 24 Sep 2009 21:40:34 +0000

The human papillomavirus, also known as HPV, comes in many forms. It has been found that HPV-16 is in fact a leading cause of oral cancer. Recently, a study at John Hopkins Oncology Center reiterated already strong findings of a link between HPV and oral cancer.

In 25% of 253 patients diagnosed with head and neck cancers, the tissue taken from tumors was HPV positive and HPV-16 was present in 90% of these positive HPV tissues. This information helps to confirm that there is a strong link between HPV-16 and oral cancer.

How Is It Contracted?

In the past, the largest cause of oral cancer was smoking. However, with the increase in smoking education and the decrease in the number of people who smoke, there has been a reduction in reported head and neck cancers. However, throat cancer rates have remained steady. Why is that? Studies reveal that HPV can be transferred through oral sex. In recent generations oral sex has become a more commonly practiced sexual act and more widely accepted among the younger population. However, with oral sex being practiced, the risk for contacting HPV, leading to oral cancer also increases.

MD Anderson released a 2007 publication stating,

“A link between throat cancer, oral sex and the sexually transmitted human papillomavirus (HPV) has prompted researchers to encourage vaccination of boys with the HPV virus if ongoing studies deem it safe and effective in preventing viral infection…”

HPV is a disease that can “hide.” Although it can be removed and may no longer be visible, if provoked by stress or another aggrevator, it can reappear. In the same way, HPVs can be in existence for a long time and yet remain dormant. Thus, a person can be at risk for oral cancer and not be aware.