Tuesday, February 5, 2008

Oral Cancer Rates for Men Linked to HPV

Frightening news: HPV is causing more oral cancer in men. HPV is a sexually transmitted infection more commonly known as genital warts. Not all kinds of HPV cause warts -- in fact, some cause no symptoms at all. HPV is so common that about three in four sexually active people will have it at some point in their lives, but most never know that they're infected. And though most HPV is harmless or only mildly irritating, it can sometimes cause cervical cancer -- which is why it's so important for women to get regular pap smears!

HPV has been in the news recently because of a debate over a new vaccine that could help to prevent most types of cervical cancer. The controversy is largely based on a claim that the vaccine would cause teenage girls to engage in more sexual activity, which simply isn't true. We also know that many teens are going to have sex no matter what, and safety should be our biggest concern for people of all ages.

It has been known for some time that HPV can cause cancer in men -- such as penile or anal cancer -- but these have mostly been quite rare. The fact that HPV is linked to growing rates of oral cancer, though, brings a new dimension to the debate:

The HPV virus now causes as many cancers of the upper throat as tobacco and alcohol, probably due both to an increase in oral sex and the decline in smoking, researchers say.

The only available vaccine against HPV, made by Merck & Co. Inc., is currently given only to girls and young women. But Merck plans this year to ask government permission to offer the shot to boys.

Experts say a primary reason for male vaccinations would be to prevent men from spreading the virus and help reduce the nearly 12,000 cases of cervical cancer diagnosed in U.S. women each year. But the new study should add to the argument that there may be a direct benefit for men, too.

"We need to start having a discussion about those cancers other than cervical cancer that may be affected in a positive way by the vaccine," said study co-author Dr. Maura Gillison of Johns Hopkins University.

[. . .]

Merck has been testing the vaccine in an international study, but it is focused on anal and penile cancer and genital warts, not oral cancers, said Kelley Dougherty, a Merck spokeswoman.

"We are continuing to consider additional areas of study that focus on both female and male HPV diseases and cancers," Dougherty said. Merck officials did not comment of Gillison's study.

Government officials and the American Cancer Society say they don't know yet whether the vaccine will be successful at preventing disease in men. No data from Merck's study are available yet.

Though the obvious assumption is that the cancer rate is caused by oral sex, oral cancer caused by HPV has gone down significantly in women. And even if it were determined that oral sex is causing the cancer increase, the solution isn't quite as simple as using condoms and dental dams. These methods will significantly lower the risk of contracting HPV, but the virus can still be present in skin surrounding the genitals. That means HPV is easier to contract than most other STDs, even with protection.

This is one of many reasons why it's incredibly important to get tested regularly for STDs. Women who are eligible for the cervical cancer vaccine should strongly consider getting it and also remember to have regular pap smears.

The next step is to develop a HPV vaccine that will prevent cancer in men. Though increased cancer rates are clearly bad news from any angle, we now know the cause. And it's good to have any information that will give researchers and lawmakers more reasons to take HPV seriously.

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