HPV-related oral cancers on the rise among males
Expert says early vaccination key to slowing cases
• Malignant tumours in the mouth and throat caused by the human papillomavirus have risen dramatically among men and could surpass the rate of HPV-induced cervical cancer in women, new statistics from the Canadian Cancer Society suggest.
In a report released Wednesday, the organization said HPV-related mouth and throat cancers jumped 56 per cent in males and 17 per cent in females between 1992 and 2012, the latest year for which statistics are available.
About 1,335 people were diagnosed with HPV-linked “oropharyngeal” cancers in 2012, and 372 died from the malignancies. That’s about one-third of all HPV cancers in Canada, equal to the proportion of cervical cancer cases, said Leah Smith, the Canadian Cancer Society epidemiologist who helped write the report.
Human papillomavirus is the most common sexually transmitted infection worldwide. Most sexually active men and women become infected with HPV at some stage. Most clear the virus in about two years, but in a small proportion, the virus persists and can later cause cancer.
This year, almost 4,400 Canadians will be diagnosed with an HPV cancer, including cervical, genital and anal cancers, and about 1,200 will die from their disease.
“HPV is a virus that infects moist skin, namely oral and genital mucosa,” said Dr. Eduardo Franco, head of oncology at McGill University, Montreal, and a worldrenowned expert on the pathogen. “The oral cavity is particularly susceptible, the tissue around the tonsils and the base of the tongue.”
Research is increasingly pointing to “deep kissing” and oral sex as major culprits in HPV transmission. A few of those infected may develop mouth and throat cancers years — even decades — later.
“The fact that we’re seeing these things now is a reflection of ... the changes in sexual mores of the ’60s and ’70s, which eventually brought oral sex to be part of people’s lives,” Franco said.
“It takes a long time for exposure of an agent to eventually develop into cancer, so much of what began (then) is rolling out now in terms of an increased risk of cancer.”
Those cases could be dramatically reduced — in fact, eliminated — if both girls and boys were inoculated against the most dangerous strains of HPV before they become sexually active, stressed Franco.
That’s a message Terry Patterson, 52, is eager to impart after being treated for throat cancer tied to infection with HPV-16, one of the most aggressive strains of the virus.
In fall 2013, the father of four children was feeling run down, his throat was persistently sore and glands in his neck were swollen. A biopsy confirmed a growth in his left tonsil was malignant.
“I was astonished,” said Patterson, an insurance executive who considered himself fairly fit despite being somewhat on the heavy side.
What followed was 35 days of radiation treatment — five days a week for seven weeks — at the Princess Margaret Cancer Centre in Toronto, each lasting about 45 minutes, as well as chemotherapy to prevent future recurrence of the tumour.
“It was a nightmare,” Patterson said from his home in Waterloo, Ont.
The man, who was recently told he is cancer-free, encourages parents to have their children vaccinated against HPV. “I don’t want anyone to go through what I did.”