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?
- Many people will likely be exposed to 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.
- Most people clear the infections on their own 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 intimate 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.
- 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.
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?
- Oropharyngeal cancer patients with HPV in their tumor live longer on average than people without HPV+ cancers (i.e. HPV-positive tumors usually respond well to therapy.)
- However, regardless of HPV status, patients who currently smoke tobacco or have smoked for a long time in the past, do not statistically live as long as patients who never smoked. Patients who are smokers should consider quitting.
Will the HPV vaccine help me?
- The HPV vaccine prevents people from getting new HPV infections.
- The vaccine will not help you clear an infection you already have.
- 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 virus.
Will my spouse / partner also get HPV-OSCC?
- This cancer remains rare among spouses of HPV+ cancer patients.
- There are no recommended screening tests for HPV-OSCC.
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.