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Oropharyngeal Cancers and HPV: What’s the Connection?

  • You may know that the sexually transmitted human papillomavirus (HPV) is tied to a higher risk of cancers of the cervix, vagina, penis, and anus. But HPV can also raise the odds significantly for oropharyngeal cancers—cancers in the back of the mouth and throat. And in recent years, cases of these cancers have increased.

    “In the past few decades, HPV has become the most common cause of throat cancers,” explained Christopher M.K.L. Yao, MD, FRCSC, a head and neck surgeon at Fox Chase Cancer Center. These cancers can form around the base of the tongue, the tonsils, the back roof of the mouth, and the posterior wall of the throat.

    HPV is a group of more than 150 viruses that cause the growth of papillomas, or warts. Papillomas are noncancerous, and the majority of those who contract HPV never experience symptoms. “Most people are able to clear it in a year or two,” Yao said.

    But some subtypes of the virus are more oncogenic (cause the development of a tumor), and have the ability to incorporate into cells and change cell DNA. That can cause the cells to grow uncontrollably—and potentially turn cancerous.

    HPV is most commonly spread through vaginal, anal, or oral sex; having more than 26 vaginal sex partners or 6 or more oral sex partners can increase the risk of developing HPV-related cancer, Yao noted. The evolution of sexual practices in recent decades means these risk factors apply to more people—leading to a rise in HPV-related oropharyngeal cancers, he explained.

    How to stay protected

    There are two HPV vaccines currently available—Gardasil® and Cervarix®—that were developed to protect against high-risk HPV infection. It’s most effective when given at age 11 or 12, before someone has become sexually active. (Though some people may benefit from vaccination up to age 45, so check with your doctor.)

    Both boys and girls should be vaccinated, according to the Centers for Disease Control and Prevention. Oropharyngeal cancers occur twice as often in men as in women. And men who are vaccinated are also less likely to pass HPV to their partners.

    No matter your vaccination status, discuss your risk for HPV-related oropharyngeal cancers with your doctor and take steps to protect yourself. Ask about opportunities for head and neck cancer screenings—they can be performed in less than five minutes at a routine checkup or dental visit.

    Be aware of other possible signs of oropharyngeal cancer, too. If you notice a lump in your neck, throat soreness, ear pain, or pain while swallowing that continues for more than a few weeks, get it checked by an otolaryngologist, also referred to as an ear, nose, and throat (ENT) doctor.

    Treating HPV-related oropharyngeal cancers

    Head and neck cancers related to HPV tend to respond to treatment more readily compared to those primarily caused by other major risk factors, like smoking or heavy drinking. “For some patients, surgery alone is enough,” Yao said.

    A dedicated cancer center like Fox Chase will offer the most comprehensive options. “Patients are treated through a multidisciplinary fashion, meeting with surgeons, medical oncologists, and radiation oncologists, allowing us to select treatments that optimize long-term quality of life” Yao said.

    And there’s high hope for treatment success. “Patients treated with HPV-positive throat cancer have disease-free survival rates of 85-90% over 5 years compared with non-HPV associated cancers, which range from 25-40%,” Yao said.