Over the past two decades, there has been a rapid increase in throat cancer in the west, to the extent that some have called it an epidemic. This has been due to a large rise in a specific type of throat cancer called oropharyngeal cancer (the area of the tonsils and back of the throat). The main cause of this cancer is the human papillomavirus (HPV), which are also the main cause of cancer of the cervix. Oropharyngeal cancer has now become more common than cervical cancer in the US and the UK.
Oral sex is fuelling an ‘epidemic’ of throat cancers, experts claim.
It comes after figures published by the American Cancer Society say the number of cases of cancer caused by oral sex is up 1.3% a year in women and 2.8% in men.
This is because the acts can lead to an HPV infection at the back of the throat or near the tonsil.
While in most cases the infections will go away on their own, some will go on to develop into throat cancer.
Scientists at NYU Langone estimate that as much as 70% of throat cancer cases are caused by HPV infections.
In the UK, head and neck cancers combined are responsible for more than 12,000 cases and 4,000 deaths per year.
Dr Mehanna said people with multiple oral sex partners have an up to nine-fold increased risk of throat cancer.
Writing in The Conversation, Dr Mehanna said: “Over the past two decades, there has been a rapid increase in throat cancer in the west, to the extent that some have called it an epidemic.
“This has been due to a large rise in a specific type of throat cancer called oropharyngeal cancer.
“HPV is sexually transmitted. For oropharyngeal cancer, the main risk factor is the number of lifetime sexual partners, especially oral sex.
“Those with six or more lifetime oral-sex partners are 8.5 times more likely to develop oropharyngeal cancer than those who do not practice oral sex.”
While there is a vaccine for HPV, figures in the US show only 54% of Americans have received it — far below the 80 percent figure believed to be a threshold for population safety.
Actor Michael Douglas has claimed performing oral sex on women triggered his throat cancer.
The Hollywood star, 68, previously blamed years of boozing and smoking for causing the illness.
But he has now said his strain was due to human papillomavirus – a sexually transmitted disease.
He said in an interview: “Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus.”
The dad-of-two said he feared the stress of seeing son Cameron jailed for drugs offences triggered his cancer.
But he added: “But yeah, it’s a sexually transmitted disease that causes cancer. And if you have it, cunnilingus is also the best cure.”
Behavioural trends studies show that oral sex is very prevalent in some countries. In a study, in almost 1,000 **people having tonsillectomy for non-cancer reasons in the UK, 80% of adults reported practising oral sex at some point in their lives. Yet, mercifully, only a small number of those people develop oropharyngeal cancer. Why that is, is not clear.
The prevailing theory is that most of people who catch HPV infections are able to clear them completely. However, a small number of people are not able to get rid of the infection, maybe due to a defect in a particular aspect of their immune system. In those patients, the virus is able to replicate continuously, and over time integrates at random positions into the host’s DNA, some of which can cause the host cells to become cancerous.
HPV vaccination of young girls has been implemented in many countries to prevent cervical cancer. There is now increasing, albeit as yet indirect evidence, that it may also be effective in preventing HPV infection in the mouth. There is also some evidence to suggest that boys are also protected by “herd immunity” in countries where there is high vaccine coverage in girls (over 85%). Taken together, this may hopefully lead in a few decades to the reduction of oropharyngeal cancer.
That is well and good from a public health point of view, but only if coverage among girls is high – over 85%, and only if one remains within the covered “herd”. It does not, however, guarantee protection at an individual level – and especially in this age of international travel – if, for example, someone has sex with someone from a country with low coverage. It certainly does not afford protection in countries where vaccine coverage of girls is low, for example, the US where only 54.3% of adolescents aged 13 to 15 years had received two or three HPV vaccination doses in 2020.
This has led several countries, including the UK, Australia and the US, to extend their national recommendations for HPV vaccination to include young boys – called a gender-neutral vaccination policy.