Oral sex is often implicated in the increase of certain head and neck cancers caused by human papillomavirus (HPV). However, research published in the Journal of Sexual Medicine suggests that there may be more to the story.
Dr. Sarah E. Rosenquist, an American sexual and reproductive health psychologist, conducted a literature review to clarify the issue and help sexual health practitioners give their patients accurate, updated information.
According to Dr. Rosenquist, there has been an overall decline in head and neck cancers since 1975. However, there has been an increase in head and neck cancers caused by HPV occurring in younger people.
It has been speculated that this “small but significant increase” has occurred because more people are having oral sex.
However, this explanation may be too simplistic.
HPV is a blanket term for approximately 70-100 viruses. Some are harmless, but others can cause disease. About 15 types, called “high-risk” types, are associated with cancer.
HPV is often considered to be sexually-transmitted, but that isn’t always the case. Dr. Rosenquist notes that even newborn babies can have HPV types in their mouths. Other studies have examined oral HPV infections in married couples and found that the types of HPV found in one partner were not always found in the other.
Much of the time, HPV infections clear on their own. But for some people, the infection becomes persistent because the body’s immune system cannot take care of it. Persistence is one of the key factors in developing HPV-related disease.
Persistence may be related to a weakened immune system. Individuals with AIDS or HIV and organ-transplant recipients who take immunosuppressant drugs are at risk. A person who has had many sexual partners (or who has sex with someone who has had many partners) may find their immune system weakened, as there is more for that system to process. Stress, long-term marijuana use, smoking, and heavy alcohol use can also affect the immune system.
Dr. Rosenquist explains that infection persistence between couples is also important. If one member has a persistent HPV infection, the other member is more likely to develop one, too.
Dr. Rosenquist also points out that oral sex is common around the world. A 2002 study by the U.S. Centers for Disease Control and Prevention (CDC) found that among over 12,000 participants, 90% of American men and 88% of American women had had oral sex with an opposite sex partner. Similar studies in other cultures showed similar results. But the incidence of head and neck cancers doesn’t correspond. “It must be noted that when base rates of a behavior are very high, correlations between behavior and vanishingly small outcomes are rendered to be virtually meaningless,” she writes.
Dr. Rosenquist also states that “HPV should not be a cause for concern among monogamous couples” as long as they stay monogamous and there are no issues with either partner’s immune system. “Sexually active adults are more likely to benefit from healthy lifestyles that promote good immune functioning coupled with regular medical checkups aimed at early detection and treatment,” she writes. However, people who are not yet sexually active should learn about HPV and how it is transmitted.
The Journal of Sexual Medicine
Rosenquist, Sara E., PhD, ABPP
“Is Oral Sex Really a Dangerous Carcinogen? Let’s Take a Closer Look”
(Full-text. First published online: March 16, 2012)
“Can Oral Sex Give You Cancer?”
(March 23, 2012)