Having oral sex with more than 10 previous participants was associated with a 4.3-fold likelihood of developing oropharyngeal cancer associated with human papillomavirus (HPV), according to new findings.
The study also found that more participants in a shorter period of time (i.e., more intense oral sex) and starting oral sex at a younger age were also associated with higher perceptions of getting associated cancer. to HPV in the mouth and throat.
The new study, published online on January 11 in Cancer, confirming previous decisions and adding more nuance, the researchers said.
Previous studies have shown that oral sex is a strong risk factor for HPV-related oropharyngeal cancer, which has increased in recent decades, particularly cancers at the base of the tongue and palatine and bilingual tonsils .
“Our research adds more nuance to our understanding of how people acquire HPV-related oral disease and HPV-related oropharyngeal cancer,” said study author Gypsyamber D’Souza, PhD, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. “He suggests that the risk of infection is not only from the number of oral sex partners but that the time and type of partner is also influencing risk. “
The results of the study do not alter clinical care or patient screening, D’Souza noted, but the study provides context for patients and providers in understanding, “Why I got HPV- cancer oropharyngeal? ” she said.
“We know that people who develop HPV-oropharyngeal cancer have a wide range of sexual history, but we do not recommend that sexual history be used for screening, as they have a low-risk sexual history. many patients, “she said.” By chance, it only takes one partner who is contagious to get the disease, but others who had many partners have a chance that they won’t find out. , or which is open but clearing the disease. “
Emphasizing the need for vaccinations
Getting an idea for, Joseph Califano, MD, chief physician at the Moores Cancer Center and director of the Head and Neck Cancer Center at the University of California, San Diego, noted that similar data have been previously published. The novel is here in time and intensity of oral sex. “It’s not new data, but it certainly confirms what we knew,” he said Medscape Medical News.
This new data is not going to change analysis, he suggested. “It’s not going to change how we screen, because we’re not going to do population-based screening for oropharyngeal cancer,” Califano said.
“It emphasizes that vaccination is a key means of preventing HPV-mediated cancers,” he said.
He pointed out that some data show lower levels of high-risk oral HPV peeling with children who have been vaccinated appropriately.
“This paper certainly emphasizes the fact that we need to get vaccinated early, before sexual intercourse,” he said. “In this case, sexual intercourse does not necessarily mean intercourse but oral sex,” he said. and that is a different concept of when sex begins. “
This new data “confirms that early publication is what we need to focus on,” he said.
Information about the new results
The current study by D’Souza and colleagues included 163 patients with HPV-related oropharyngeal cancer enrolled in the Papillomavirus Role Study in Oral Cancer Viral Epidemiology (PROVE) study. These patients were compared to 345 matched control individuals.
All participants completed a behavioral study and provided a blood sample. For the cancer patients, a tumor sample was obtained.
The majority of male participants (85% and 82%), aged 50 to 69 years, were currently married or living with a partner, and identified as heterosexual. Case patients were more likely to report a history of sexual infection than control participants (P. = .003).
Case patients were ever more likely to have oral sex compared to control pesons (98.8% vs. 90.4%; P. <.001) and having had oral sex during their first sexual intercourse (33.3% of case patients versus 21.4% of control people; P. = .004; odds ratio [OR], 1.8).
Many more case patients than control people reported starting oral sex before the age of 18 (37.4% of case patients versus 22.6% of control people; P. <.001; NO, 3.1), and had a greater number of lifelong oral sex partners (44.8% of case patients and 19.1% of control patients reported having more than 10 partners; P. <.001; NO, 4.3).
The intensity of oral sexual expression, measured by the authors according to the number of participants every 10 years, was also significantly higher among case patients than the control people (30.8% vs. 11.1%; P. <.001; NO, 5.6).
After adjustment for confounders, such as the lifetime number of oral sex partners and tobacco use, ever perform oral sex (ratio of odds changed) [aOR], 4.4), early age of first oral sex encounter (20 years: aOR, 1.8), and intense oral sex (aOR, 2.8) were still significantly associated with increased odds of HPV-oropharyngeal cancer.
The type of sexual partner, such as partners who were older (OR, 1.7), and who have a partner who was involved in extramarital sex (OR, 1.6) was also associated with increased odds of being developing HPV-oropharyngeal cancer. In addition, seropositivity for antibodies to HPV16 E6 (OR, 286) and any HPV16 E protein (E1, E2, E6, E7; OR, 163) was also associated with increased odds of developing a ‘disease.
The study was supported by the National Institute of Dental and Craniofacial Research and the National Institute on Deafness and Other Communication Disorders. D’Souza and Califano have not disclosed any material financial relationships.
Cancer. Published online early January 11, 2021. Summary
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