HPV, Not Tobacco, is Major Cause of Oral Cancers

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While smoking, other tobacco use and alcohol consumption continue to be major risk factors for oral cancers, as it turns out they are not the primary causes. Most would be surprised to learn the human papillomavirus, or HPV, is the main culprit of head, neck and throat cancers.

shutterstock_370574183 HPV vaccine via Shutterstock

While tobacco use and alcohol consumption continue to be touted as major risk factors for head, neck and throat cancers, it turns out they are not the primary causes. Instead, the primary cause is a virus - the human papillomavirus (HPV).

The “fastest growing segment of oral cancer patients" has nothing to do with tobacco, they are instead young, healthy, nonsmoking individuals, according to The Oral Cancer Foundation. An estimated 14 million new HPV infections occur every year in the United States alone, with approximately half of these infections occurring among men and women ages 15 to 24.

Though the perceived link between oral cancer and tobacco is strong among the public, in general tobacco users are not exposed to high enough levels of cadmium, lead and formaldehyde to be oral cancer causes. A review paper in Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, based on 10 published studies, found that when it comes to smokeless tobacco users, that product imposes "minimal risk for cancers of the oral cavity and other upper respiratory sites."

Instead, a readily-available vaccine might do a lot more good than worrying about cigars or snus. There are over 150 documented varieties of HPV and the high-risk strains (types 16 and 18) have the potential to act as carcinogens. The Centers for Disease Control estimates that more than 10,000 new cases of HPV-associated oropharyngeal cancers are diagnosed in the United States each year. HPV has remained problematic for two reasons: Its ease of transmission (sex) and infected individuals remain asymptomatic for years.

The solution is already there: Getting vaccinated. Two HPV vaccines protect against HPV types 16 and 18. The CDC’s Advisory Committee on Immunization Practices for use of HPV vaccines recommends that females between the ages of 13 and 26, and males between the ages of 13 and 21 years old, get vaccinated.

But despite these recommendations, barriers like wariness among some demographics about vaccines in general and promoting awareness among the public about the fact that there actually is a vaccine that will likely prevent cancer, continue to be a challenge.

Increased efforts geared towards educating parents, providers and patients also need to be implemented to eliminate missed opportunities for vaccination. HPV vaccines are not licensed in the United States for use in individuals over 26 years old.

From a prevention standpoint, it's important to broaden the public’s perception about the true causes of oral cancer, not the perceived causes.