WASHINGTON, June 4, 2013 – In an interview last week, Michael Douglas stated that genital human papillomavirus (HPV) transmitted through oral sex resulted in his 2010 throat cancer diagnosis.
Douglas’ spokespeople later denied the statement but it did raise the question: can you get throat cancer from oral sex?
The answer is yes, but a few may not agree.
“Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus,” Douglas allegedly said during the now infamous interview with The Guardian.
After the statement made headlines, Douglas’ publicist explained that the “Behind the Candelabra” star was misinterpreted.
According to the publicist, Douglas said that oral sex is a suspected cause of certain oral cancers, but not the particular cause of Douglas’ cancer.
Oral cancers like the one suffered by Douglas are on the rise in the U.S. Previously associated with smoking and alcohol consumption HPV has replaced tobacco as the leading cause of throat cancers.
Of the 11,726 cases of oropharyngeal cancer (a type of oral cancer in the back of the throat including the base of the tongue and tonsils) diagnosed each year, 63 percent are attributed to HPV.
“It is a known phenomenon,” said Dr. Maura Gillison, professor at the Ohio State University to Time Magazine. “In the U.S., there is an active shift going on. Fortunately thanks to tobacco policy and public-health awareness, the incidence rate for the classical head and neck cancer caused by smoking is declining. But unfortunately, the rate of oropharynx cancer is still going up and it’s because of the HPV component.”
HPV is the most common sexually transmitted infection, with over 150 strains, 40 of which can be transmitted through sexual contact. HPV is passed through vaginal and anal sex, and “may also be passed on during oral sex and genital-to-genital contact,” according to the Centers for Disease Control and Prevention (CDC).
A person can be infected with HPV for years without knowing it, and most HPV strains clear up on their own. According to certain estimates, nearly 50% of sexually active Americans will have HPV during their lifetimes. Most people never develop any symptoms or health problems associated with HPV.
However, according to the CDC, HPV can cause genital warts and cervical cancer. In rare cases, HPV can cause recurrent respiratory papillomatosis (RRP), where warts grow in the throat; genital cancers; and oropharyngeal cancer, like the one Douglas was diagnosed with.
Men are three times more likely to be diagnosed with this type of throat cancer than women.
Of concern are the strains HPV-18 and HPV-16, which can be contracted through oral sex. According to the National cancer institute, HPV-16 is responsible for half of all oral cancer cases.
Cervarix and Gardasil, the two FDA approved HPV vaccines, target HPV-16 and 18. CDC currently recommends Gardasil for boys between the ages of 13 and 21 and both Cervarix and Gardasil for girls aged 13 to 26.
In the wake of the Michael Douglas interview, many question the exact link between oral sex and HPV infection. As The Daily Beast points out, even though it is clear that sexual activity in general is linked to HPV infection, it may not be clear exactly which sexual activity is the risky one.
The Daily Beast article cites the largest HPV study to date, finding that “the lifetime number of sex partners conferred as much risk for oral cancer as does oral sex. They also noted that between 8 percent and 40 percent of patients with HPV-associated cancers reported no previous oral sex at all.”
To date, there is no screening test to determine overall HPV status, even though women do get screened routinely for HPV-associated cervical cancer via Pap-smear tests. Nevertheless, according to the Oral Cancer Foundation, HPV-associated oral cancers have an 80 to 90 percent survival rate.
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