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Common questions & answers about HPV-positive oropharyngeal squamous cell cancer (HPV-OSCC)

What is Human Papillomavirus (HPV)?

  • HPV is a sexually transmitted infection that can infect the oropharynx (tonsils, base of tongue and back of throat), anus, and genitals.
  • There are many types of HPV. HPV can cause cancer, warts or have no effect.
  • HPV is very common in the U.S. Over 20 million Americans have some type of genital or oral HPV infection at any moment in time.

What causes oropharyngeal cancer?

  • HPV now causes most oropharyngeal cancers in the U.S.
  • It is recommended that oropharyngeal tumors be tested for HPV.
  • Smoking and alcohol use can also cause oropharyngeal cancer.

How did I get an oral HPV infection?

  • HPV is transmitted to your mouth by oral sex. It may also be possible to get oral HPV by other ways.
  • Performing oral sex and having many oral sex partners can increase your chances of oral HPV infection.
  • Having an oral HPV infection does not mean your partner was/is unfaithful and does not suggest promiscuity.
  • Many people with HPV-OSCC have only had a few oral sex partners in their life.

Who has oral HPV infection?

  • Most Americans will likely be exposed and infected with an oral HPV in their life, most in their early years of sexual experiences.
  • At any point in time, around 10% of men and 3.6% of women in the U.S. have an active HPV in their mouths, and HPV infection is more commonly found with older age. The ongoing NHANES study has clearly shown that on any given day about 26 million Americans have an active oral HPV infection.
  • Most people clear the infections through their own immune response within a year or two, but in some people HPV infection persists.
  • There is no known treatment for HPV infections.

Can I transmit oral HPV infection to others?

Family and friends:

  • Oral HPV is not casually transmitted by sharing drinks or simple kissing on the lips. It is unknown if penetrating type kissing (French kissing) is capable of transferring an infection. 
  • HPV is not transferred by inanimate objects such as sharing a spoon or on surfaces such as doorknobs.

Partners of people with HPV and HPV+OSCC:

  • You have already likely shared whatever infections you have. Long term sexual partners share all the same sexual infections from fungal and bacterial infections to viral infections like HPV. 
  • You do not need to change your sexual behavior.
  • Female partners should have regular cervical Pap screening along with the current HPV recommended cervical test.
  • Partners of oral cancer patients who have an HPV etiology, are no more at risk for developing an oral or oropharyngeal cancer than anyone else in the general population. 

New sexual partners in the future:

  • Many patients with HPV-OSCC no longer have HPV detectable in their mouth after treatment, while others do.
  • With new partners, discuss protection methods (e.g., con-doms and barrier protection).

New sexual partners in the future:

  • Many patients with HPV+ oropharyngeal cancers no longer have HPV detectable in their mouth after treatment, while others do. The reasons for this are poorly understood at this time.
  • With new partners, discuss protection methods (e.g., condoms and barrier protection).

When did I get my HPV infection that lead to a cancer ?

  • We do not know the time from first oral HPV infection to occurrence of a cancer but it takes many years, and when considering the entire US population, is a relatively rare occurance 
  • We know that some people have infection 15 years or more before cancer development.

When did I get this infection that caused my cancer?

  • It is not possible to know at this time exactly when the original infection occurred that prospered over possibly decades into a current cancer.

Will the HPV vaccine help me?

  • The HPV vaccine prevents people from getting new HPV infections. It is only effective in people who have not yet been exposed to the virus, meaning it is most effective if given to children before the sexual debut. 
  • The vaccine will not help you clear an infection you already have. It is not a therapeutic vaccine, but a preventative vaccine. 
  • The vaccine is recommended for people ages 9-26 years old. It is belied that by 26 people who are normally sexually active have already been exposed to the versions of the virus that the vaccine covers. 

Will my spouse / partner also get HPV-OSCC?

  • This cancer remains extremely rare among spouses of HPV+ cancer patients. A peer reviewed published study out of Johns Hopkins shows that spouses of HPV+ cancer patients are no more at risk for developing an oral cancer than the general population. 
  • There are no recommended screening tests for HPV-OSCC.

Additional Information

A comprehensive list of references is available in: Fakhry C. and D’Souza G. Discussing the diagnosis of HPV-OSCC: Common questions and answers. Oral Oncology. 2013.