Oral HPV infection can cause cancer

Q: How do you get oral HPV infection? What's the risk of getting cancer from it? How can I protect myself?

A: Human papillomavirus is transmitted during sexual contact. According to the Centers for Disease Control and Prevention, HPV infection is the most common sexually transmitted disease. Having multiple sexual partners or sex with someone with a history of multiple sexual partners is a risk factor, and people who smoke are more susceptible to infection. Oral HPV infection is believed to be transmitted during oral sex.

There are many types of HPV, and the vast majority cause no problems or symptoms. Some strains cause warts, but these do not turn into cancer. The cancer most associated with HPV is cervical cancer. But it also is implicated in penile, anal, and oral cancer.

Over 10 to 20 years, a previously undetected oral HPV infection can turn into cancer in the back of the throat, the tonsils, or at the base of the tongue. It may spread to lymph nodes - the most common initial sign of an HPV-related throat cancer is a new lump in the neck, often discovered while shaving or washing.

Barrier methods such as condoms and dental dams, if used properly and consistently, may protect against oral HPV infection.

An HPV vaccine has been shown to protect against both cervical and oral infection with HPV 16 and 18. Because it takes many years for HPV infection to turn into cancer, it also will take time to prove that the vaccine prevents cancer, though physicians believe it will. A quadrivalent HPV vaccine targeting HPV 6, 11, 16, and 18 has been licensed in the United States for use in females age 9 to 26 since June 2006, and in males age 9 to 26 since October 2009. The vaccine must be given before exposure to the virus during sexual activity. It is recommended for both boys and girls.

Although the Pap test is used to screen women for cervical precancer caused by HPV, there is no comparable test for throat cancer. Additional research is needed.

- Miriam Lango, a head and neck cancer surgeon at Fox Chase Cancer Center.