The rate of oropharyngeal cancer[1] has gone up significantly among young adults over the last 35 years, according to a new study -- an increase that may be caused, at least in part, by the most common sexually transmitted infection[2] , human papillomavirus.


Oropharyngeal cancers include cancers of the base of the tongue, pharynx (throat), soft palate and tonsils. Researchers found that the rate of these cancers increased 60 percent between 1973 and 2009 among people under age 45.


However, researchers found that the rate of increase differed drastically between racial groups -- oropharyngeal cancers increased 113 percent for white people, while it actually decreased by 52 percent for African Americans.


"Not only were we surprised to find a substantial increase in young adults with cancer of the tonsils[3] and base of tongue, but also a wide deviation among Caucasians and African Americans with this cancer," study researcher Dr. Farzan Siddiqui, M.D., Ph.D., director of the Head & Neck Radiation Therapy Program in Henry Ford Hospital's radiation oncology department, said in a statement.


The findings were presented at the annual meeting of the American Society for Radiation Oncology. For the study, researchers analyzed data from the Surveillance Epidemiology and End Results (SEER) database, of more than 1,600 adults under age 45 (majority were between 36 and 44) diagnosed between 1973 and 2009 with invasive squamous cell oropharyngeal cancer. Seventy-three percent of the people in the study were white.


Even though information on HPV status was not available for the people in the database, researchers were able to extrapolate HPV status from tumor grade.


Researchers found that the survival rate over five years for people in the study was 54 percent, with men and women having similar survival rates, but African Americans having worse survival rates than white people.



"The growing incidence in oropharyngeal cancer has been largely attributed to the sexual revolution of the 1960s and 1970s, which led to an increased transmission of high-risk HPV," Siddiqui said in the statement.


HPV is a known risk factor for both oral[4] and throat cancers[5] . The Mayo Clinic points out that other risk factors for throat and oral cancers include tobacco use and excessive alcohol consumption.


In addition to oropharyngeal cancers, persistent HPV infection[6] can also cause genital warts, cervical and genital cancer, and a wart condition called recurrent respiratory papillomatosis, according to the Centers for Disease Control and Prevention.



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  • An Abnormal Pap Test Means You Have High-Risk HPV


    Pap tests are the commonly accepted screening to prevent cervical cancer. A doctor scrapes a cell culture from a woman's cervix and then examines the cells for signs of abnormality. But just because a few of those cells appear abnormal, requiring further screening, doesn't necessarily mean that you've got a cancer-causing strain of HPV -- that's only one potential cause. "The difference could be due to local irritation, a non-HPV infection, a low-risk HPV type, or even a mistake in the preparation of the cell sample," writes the American Sexual Health Association.




  • Condom Use Prevents HPV


    HPV is passed via skin contact, rather than bodily fluid. For that reason, condoms can <em>lower</em> the risk of the disease, but they are not a sufficiently preventive measure, as they are for viruses like HIV and bacteria like gonorrhea.




  • Oral Sex Is Safe From Cancer Risk


    While the HPV-cancer connection most often relates to cervical health, a 2011 <em>Journal of Clinical Oncology</em> study found what doctors have long observed: There has been a surge in HPV-associated oral cancers. In fact, between 1988 and 2004, <a href="http://nyp.org/enews/oral-sex-hpv.html">HPV-associated oropharyngeal cancers rose 225 percent</a>. Oral sex is the primary culprit, making cancer screening of the mouth and esophagus another important test while visiting the doctor.




  • HPV Vaccine Means I Don't Have To Worry About Cervical Cancer


    The HPV vaccine protects against four strains of the virus that are most often associated with cancer and genital warts, but that doesn't mean it prevents cancer entirely. One concern within the medical community is that the vaccination will <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104818/">provide a false sense of security</a> and prevent innoculated men and women from receiving regular cancer screening. "Clearer information is needed concerning the incomplete protection offered by the vaccine, and that cervical screening will still be required," wrote a group of British public health researchers in the <em>Journal of Medical Screening</em>.




  • HPV Is A Serious, Life-Long Condition


    About 90 percent of HPV infections <a href="http://www.cdc.gov/vaccines/pubs/surv-manual/chpt05-hpv.pdf">are resolved by the body's immune system</a>.




  • Genital Warts Can Be Pre-Cancerous


    Some strains of HPV (<a href="http://www.ashastd.org/std-sti/hpv/myths-and-misconceptions.html">"low risk" types 6, 11, 42, 43 and 44</a>) cause benign growths known as genital warts and other strains (types 16, 18, 31 and 45) cause cancer of the cervix, vulva, vagina, penis, anus, or an area called the oropharynx, which includes the back of the throat, the base of the tongue and the tonsils. But that doesn't mean that one leads to the other -- genital warts, <a href="http://www.cdc.gov/std/hpv/stdfact-hpv.htm">which affect about one percent of the sexually active U.S. adult population</a> -- do not lead to cancer.




  • The HPV Vaccine Is For Girls


    The first HPV-preventive vaccine on the market, Gardasil, was approved by the FDA for use in girls in 2006 and <a href="http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm187003.htm">in boys three years later</a>. What's more, there are <em>two</em> FDA-approved vaccines for girls and women: Gardasil and Cervarix; while only Gardasil is available to boys and men. Still, HPV vaccination is the responsibility of all. Both the Centers for Disease Control and Prevention and the American Academy of Pediatrics both recommend the vaccine for boys for two primary reasons. First, inoculated boys will not be vectors for the disease, which can contribute to herd immunity and prevent dangerous infection in women. But more, the incidence of HPV-associated cancers that affect men is also growing, including anal and penile cancer and cancers of the mouth and throat.




  • Girls Who Receive An HPV Vaccine Will Be More Sexually Active


    <a href="http://www.time.com/time/nation/article/0,8599,1206813,00.html">Despite initial hand-wringing</a> that the vaccine could lead to promiscuity, a study of adolescent girls -- both those who had been inoculated and those who hadn't -- found no evidence that those who received the vaccination engaged in riskier behavior: they were no more likely to contract an STI, become pregnant or even seek out contraception -- a measure of intended sexual activity. "HPV vaccination in the recommended ages was not associated with increased sexual activity–related outcome rates," <a href="http://pediatrics.aappublications.org/content/early/2012/10/10/peds.2012-1516.abstract%7CSexual">the researchers wrote</a>.