HPV oral and oropharyngeal cancers are harder to discover than tobacco related cancers because the symptoms are not always obvious to the individual who is developing the disease, or to professionals that are looking for it. They can be very subtle and painless. A dentist or doctor should evaluate any symptoms that you are concerned with, and certainly anything that has persisted for two or more weeks. The best way to screen for HPV related oral and oropharyngeal cancer today is through a visual and tactile exam given by a medical or dental professional, who will also do an oral history taking to ask about signs and symptoms that cover things that are not visible or palpable. Most of the symptoms of a developing HPV positive infection are discovered by asking questions not using a test, a light or other device to do so. Like other cancer screenings you engage in, such as cervical, skin, prostate, colon and breast examinations, opportunistic oral cancer screenings are an effective means of finding cancer at its early, highly curable stages.
- HPV is the most common sexually transmitted virus and infection in the US.
- There are nearly 200 different strains of HPV, most of which are harmless and do not cancer. Out of all these, 9 are known to cause cancers, and another 6 are suspected of causing cancers as they are commonly found along with one of the nine we know to be oncogenic. In oral cancers, we are primarily concerned with HPV number 16 which is also associated with cervical, anal, and penile cancers besides those of the oropharynx.
- You can have HPV without ever knowing it because the virus often produces no signs or symptoms that you will notice, and the immune response to clear it is not a process that you will be aware of.
- Every day in the US, about 12,000 people ages 15 to 24 are infected with HPV. According to data from the ongoing NHANES study, approximately 26 million Americans on any given day have an oral HPV infection. Of those approximately 2600 are HPV16. The vast majority of individuals will clear the virus naturally through their own immune response, and never know that they were exposed or had it.
HPV and Oral Cancer
- HPV is the leading cause of oropharyngeal cancers; primarily the tonsils, tonsillar crypt, the base of the tongue (the very back of the mouth and part of what in lay terms might be called a part of the throat), and a very small number of front of the mouth, oral cavity cancers. HPV16 is the version most responsible, and affects both males and females.
- White, non-smoking males age 35 to 55 are most at risk, 4 to 1 over females.
- In the oral/oropharyngeal environment, HPV16 manifests itself primarily in the posterior regions (the oropharynx) such as the base of the tongue, the back of the throat, the tonsils, the tonsillar crypts, and tonsillar pillar
- Number of sexual partners- The greater your number of sexual partners, the more likely you are to contract a genital HPV infection; and when engaging in oral sex, this also holds true for oral infections. Having sex with a partner who has had multiple sex partners also increases your risk.
- Weakened Immune Systems- People who have weakened immune systems are at greater risk of HPV infections. Immune systems can be weakened by HIV/AIDS or by immune system-suppressing drugs used after organ transplants.
Oral Cancer Signs and Symptoms:
- An ulcer or sore that does not heal within 2-3 weeks
- A red, white, or black discoloration on the soft tissues in the mouth
- Difficult or painful swallowing. A sensation that things are sticking in the throat when swallowing
- A swollen but painless tonsil. When looking in the mouth, tonsils on both sides should be symmetrical in size
- Pain when chewing
- A persistent sore throat or hoarse voice
- A swelling or lump in the mouth
- A painless lump felt on the outside of the neck, which has been there for at least two weeks.
- A numb feeling in the mouth or lips
- Constant coughing
- An earache on one side (unilateral) which persists for more than a few days
How do people get HPV?
- HPV is passed on through skin to skin genital contact, most often during vaginal, anal and oral sex.
- You are more likely to get HPV if you have many sex partners or a sex partner who has had many partners.
- Many people don’t have symptoms and are unaware that they have HPV. They will be equally unaware when they clear it through natural immune responses to it.
- The virus may be inactive for weeks, months and for some people possibly even years after infection.
Source: The Oral Cancer Foundation