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Thursday, January 27, 2011

Rise in Some Head and Neck Cancers Tied to Oral Sex: Study

There is an alarming rise in the incidence of certain types of head neck cancer among middle-aged and younger Americans, and some experts link the trend to an increase in the popularity of oral sex during the last decades.

That's because the human papilloma virus (HPV) is an important trigger for these cancers, and HPV can be transmitted through this type of sexual activity.

"It seems like a very good link that increased sexual activity, including oral sex is associated with increased HPV infection," said Dr. Greg Hartig, professor of otolaryngology - head and neck surgery at the School Wisconsin University of Medicine and Public Health in Madison.

According to Dr. William Lydiatt, professor and chief of oncology of head and neck surgery at the University of Nebraska Medical Center in Omaha, the overall incidence of cancer of the head and neck going down, largely because fewer people are smoking ( snuff and drink are the major traditional risk factors).

However, the incidence of cancers of the tonsils and base of the tongue have been rising in recent decades, he said. And those are the ones most likely to test positive for HPV.

"It's gotten to the point where 60-70 percent of all cancers of the tonsils in the U.S. are related to HPV," said Lydiatt.

Although the relationship between HPV and this type of cancer is indisputable, the association with oral sex is strong, but a bit more speculative, experts say.

A 2007 study in the New England Journal of Medicine found that younger people with head and neck cancer who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in your life.

In the study, which has six or more oral sex partners during a lifetime was associated with a 3.4 times greater risk of oropharyngeal cancer - cancer of the base of the tongue, back of the throat or tonsils. Having 26 or more vaginal-sex partners tripled the risk.

And the association increased its membership - in every category - increased.

The researchers also reported that cancers of the tonsils and base of the tongue have increased every year since 1973, and wrote that "the spread of oral sex practices among adolescents may be a contributing factor to this increase."

The researchers concluded that, in their study, oral sex was "strongly associated" with oropharyngeal cancer, but said he could not "rule out transmission through direct mouth-to-face contact" kisses, as French.

In 90 percent of cases of HPV infection in the body, the immune system clears HPV naturally within two years, according to federal health agencies, but in some cases, certain types of HPV can cause cervical cancer and less common cancers, and oropharyngeal cancer. A 2010 study in Sweden, in fact, suggests that the increase in oropharyngeal cancer of squamous cells in a number of countries is caused by a slow epidemic of infection with HPV-induced [cancer]. "

HPV tends to be site-specific, said Dr. A. AMESH Adalja, an associate professor in the division of infectious diseases at the University of Pittsburgh Medical Center. In other words, tends to be always first enters the body, either the vagina (in some cases could lead to cervical cancer), or the mouth and throat.

The same applies to the increased incidence of saying that the latest generations are having more sex than their grandparents?

"The general consensus on the street because people are that the practices [sexual] have changed over time, we are seeing an increase in these types of cancer," said Hartig. "I do not know why they are having more oral sex [but] the concept of having oral sex is something that seems less dark for you as you did with your parents or grandparents."

"The idea would be that the" Baby Boomers "- the generation of the 70's and early 60's - probably had more freedom in sexual relations in general, including oral sex," said Dr. Bert W. O'Malley, Jr. , Chairman of otolaryngology - head and neck surgery at the University of Pennsylvania.

And at least in terms of oral sex, which seems true for the children of the Boomers.

The U.S. Centers Control and Prevention (CDC) reports that in 2002, about 90 percent of men and 88 percent of women aged 25 to 44 reported having oral sex with a partner of the opposite sex.

The comparative figures for 1992 showed that about three quarters of men aged 20 to 39 and about 70 percent of women aged 18 to 59 who have sex ever given or received orally.

The positive side is that HPV-related head and neck cancer are eminently more treatable than those attributable to smoking or drinking, although they tend to be diagnosed at a later stage.

"[The head and neck cancers associated with HPV] have been much easier to treat. You can use less intense radiation," said Dr. DJ Verret, assistant clinical professor at the University of Texas Southwestern Medical School and a facial plastic surgeon in Plano, Texas.

About 85 percent of nonsmokers with HPV positive tumors survive. That figure drops to 45 or 50 percent in people who smoke and are HPV-negative, Lydiatt said.

And the tongue and tonsil cancers are still relatively rare in the United States. The other good news - at least for the youngest - is that there is a relatively new vaccine to prevent HPV infection. It will not help those already infected, but "absolutely" could help those not yet infected with the virus are ubiquitous, Verret said.

Meanwhile, the people, especially youth, need to realize that smoking is not the only risk factor for head and neck cancer. If you find a lump in the neck, even if you are only 20 or 30, "pay attention to that," said Lydiatt.

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