Oropharyngeal cancer a growing result of HPV’s spread

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo: AJ Cann via Flickr

With about 14 million new infections a year, human papillomavirus (HPV) is the most prevalent sexually-transmitted virus in the United States.

HPV has long been linked to cervical cancer. Certain strains of the virus cause an estimated 12,000 cases of cervical cancer annually among women in the U.S. Now, rising rates of HPV-linked mouth and throat cancers – known as oropharyngeal cancers – are receiving increased attention, as are efforts to get Americans up to age 45 vaccinated to reduce the spread of HPV-related diseases.

Researchers recently confirmed that oropharyngeal squamous cell carcinoma (SCC) had surpassed cervical cancer as the most common HPV-linked cancer in the U.S.  Men are about four times as likely as women to be diagnosed with the disease. Federal data for 2015 revealed 15,479 cases of HPV-related oropharyngeal SCC among U.S. men, compared with 3,438 among women.

Changing patterns of sexual behavior, including unprotected oral sex, are believed to have contributed to the increase. The malignancies, which sometimes take years to develop, can occur after the virus infects the oropharynx – an area that includes the back of the throat including the base of the tongue and the tonsils. Earlier research suggested that vaccination against HPV may sharply reduce oral infections identified as a major risk factor for HPV-related oropharyngeal cancer.

“In the United States, more than half of oropharyngeal cancers are linked to a single high-risk HPV type, HPV 16, which is one of the types covered by U.S. Food and Drug Administration (FDA)-approved HPV vaccines,” the National Cancer Institute noted in a report on the findings.

For more than a decade, routine HPV vaccination has been reco mmended for 11- to 12-year-old girls and young women up to age 26 not previously vaccinated. Since 2009, the vaccine also has been recommended for males ages 9 to 26.

In October, the FDA approved the expanded use of the current HPV vaccine Gardasil 9, to include women and men ages 27 to 45 years.

The approval “represents an important opportunity to help prevent HPV-related diseases and cancers in a broader age range,” Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in the announcement.

“Experts say the vaccine, which protects against nine HPV strains, is most effective when administered before the initiation of sexual activity,” wrote Laurie McGinley in a story for the Washington Post. “But data also indicate that the vaccine can benefit the older group. That’s because even though many adults have been exposed to some types of HPV, most have not been exposed to all nine types covered by the vaccine.”

For resources that can help you report on this virus, check out this new AHCJ tip sheet.

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