Surgical Diseases

HPV and oral Cancers (Oro-pharangeal cancers)

HPV infection with certain serotypes are known to cause cancers. These infections are known to cause pre-cancerous lesions like anal dysplasia, cervical dysplasia, Oro-pharangeal cancers

The oral sex is known to cause HPV infection in oral cavity and throat. The infection with HPV over a long time can cause oro-pharangeal cancer. Human papillomavirus–related oropharyngeal cancer (HPV‐OPC) is a distinct entity associated with number of oral sex partners¹.

Genito-oral transmission of Human Papilloma virus to the oro-phyarynx during oral sex indues early humoral immune response due to presence of high concentration of lymphoid tissue present in oro-pharynx resulting in abortive infections. But patients who develop Be-cell induced humoral response to HPV infection but no cellular cytotoxic T-cell response to HPV infection develop oro-pharngeal cancers. Most of HPV infections are cleared by immunity of the person but a minority of people who are not able to mount an effective immune response to this HPV infection develops oro-pharangeal cancers².

Higher Oro-pharangeal cancer incidences in males suggest that performing oral sex on females might confer a higher risk of oropharyngeal HPV infection. This could be caused by a potentially more efficient genito-oral transmission from the female genital tract to the male oropharynx due to i) potentially higher viral loads in the female genital tract or ii) existing neutralising antibodies in females elicited by a previous genital infection which prevent a secondary oropharyngeal HPV infection².

Human papilloma virus in the infected male is also secreted in the semen³. Persons indulging in oral sex with ejaculation into oral cavity are more prone to get oral HPV infections and high risk of development of oro-pharangeal cancer. Similarly the HPV infection through semen is spread into anal canal and vagina.

References

1. Drake VE, Fakhry C, Windon MJ, Stewart CM, Akst L, Hillel A, Chien W, Ha P, Miles B, Gourin CG, Mandal R, Mydlarz WK, Rooper L, Troy T, Yavvari S, Waterboer T, Brenner N, Eisele DW, D'Souza G. Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer. Cancer. 2021 Jan 11. doi: 10.1002/cncr.33346. Epub ahead of print. (Abstract).
2. Brenner N, Mentzer AJ, Hill M, Almond R, Allen N, Pawlita M, Waterboer T. Characterization of human papillomavirus (HPV) 16 E6 seropositive individuals without HPV-associated malignancies after 10 years of follow-up in the UK Biobank. EBioMedicine. 2020 Dec;62:103123. doi: 10.1016/j.ebiom.2020.103123. Epub 2020 Nov 25. PMID: 33248371; PMCID: PMC7704422.
3. Capra G, Schillaci R, Bosco L, Roccheri MC, Perino A, Ragusa MA. HPV infection in semen: results from a new molecular approach. Epidemiol Infect. 2019 Jan;147:e177. doi: 10.1017/S0950268819000621. PMID: 31063107; PMCID: PMC6518472.