Partying's unsexy effect

Combination of oral sex, smoking, drinking can lead to mouth cancer

By: Catherine Basham

Posted: 9/13/07

Your mother always said to be careful about what you put in your mouth. Now she has a new reason why.

When transmitted during oral sex, human papillomavirus (HPV) - the sexually transmitted infection commonly associated with cervical cancer in women - can lead to oral cancers, according to a study published in The New England Journal of Medicine.

Previously, oral cancers were most closely associated with tobacco or alcohol use. But in recent years, there has been an increase in the rates of oral cancer, especially among younger people who are not heavy smokers or drinkers.

"Oral sex is sex. Like other sexual acts, you want to protect yourself in a similar way that you would protect yourself from other sexually transmitted diseases," said Dr. Gypsyamber D'Souza, senior author of the study and assistant scientist at Johns Hopkins University.

But out of a handful of Syracuse University students, oral sex is still widely considered to be a safer alternative to vaginal sex.

Christine Fitzsimons, a freshman in The College of Arts and Sciences, said today's culture portrays oral sex as more commonplace, and young people are likely to think of it that way, too.

"I think it's becoming less and less of a taboo thing and a lot more socially acceptable," she said.

Though the study found that most adults with throat cancer contracted it during oral sex, it allows for the possibility that the virus was exchanged during kissing. But those who have many sex partners are probably kissing a lot of people as well, so it's hard to separate out which behaviors may cause the virus, D'Souza said.

"But because oral sex is so widespread and common now, and people are having so many partners, it suggests that in the future, the problem might become even larger," she said.

The study sample included 100 adults with throat cancer and 200 without it. Those with HPV were 32 times more likely to develop a form of oral cancer than those without the virus.

D'Souza added it's important to realize that it can take 10 years or more to develop a cancer from an HPV infection, so the data reflects sex habits of people 10 years ago.

Freshman John Canlas said he is not surprised by the study's findings.

"During oral sex, there's a transmission of bodily fluids," he said. "You have to be a completely oblivious person to think that nothing could be transmitted."

There are more than 100 types of HPV, but only 30 can be transmitted sexually, and only 10 can lead to types of cancer, according to the Center for Disease Control (CDC). Only a very small proportion of those infected with persistent strains of "high-risk" HPV ever develop cancer.

"It's important to know that HPV is a very, very common STD, and many people become infected during their lifetime, but a vast majority of those people clear the infection themselves with no problem," D'Souza said. "Most people who have HPV will not develop cancer."

During oral sex, HPV is established in the squamous cells, located in the upper layer of tissue in one's mouth or throat. Cuts or trauma - which can be caused by drinking and smoking - make it more like for a person to contract the disease.

About 20 million people are currently infected with HPV, with 6.2 million new cases diagnosed each year. Fifty percent of sexually active men and 80 percent of women will have an HPV infection at some point in their lives, according to the CDC.

In 2006, the Food and Drug Administration approved the vaccine Gardasil, which protects recipients against four types of HPV. Previously, many experts believed only women needed to be vaccinated because they were susceptible to cervical cancer. But as a result of the new study's findings, opinions may shift because oral cancer affects men and women indiscriminately.

Last fall, SU Health Services began administering Gardasil to interested students. SU was one of only a few schools that would vaccinate men upon request.

Health Services declined to comment for this article.