This Week From The New York Times: Men Carry Cancer-Causing Oral HPV

[PeterJ 954]

Most of us men on this forum would be considered at relatively high risk for oral HPV and the serious diseases associated with it. For more than 50 years I’ve been giving head to way more women than I can count. I guess I probably should have this added the next time I am tested.

 

7 Million American Men Carry Cancer-Causing HPV

 

Men Carry Cancer-Causing HPV

By NICHOLAS BAKALAROCT. 16, 2017

 

The incidence of mouth and throat cancers caused by the human papillomavirus in men has now surpassed the incidence of HPV-related cervical cancers in women, researchers report.

 

The study, in the Annals of Internal Medicine, found that 11 million men and 3.2 million women in the United States had oral HPV infections. Among them, 7 million men and 1.4 million women had strains that can cause cancers of the throat, tongue and other areas of the head and neck.

 

The risk of infection was higher for smokers, for people who have had multiple sex partners, and for men who have sex with men. Frequent oral sex also increased the risk. The rate was higher among men who also had genital HPV. (Almost half of men aged 18 to 60 have a genital HPV infection, according to the Centers for Disease Control and Prevention.)

 

Neither age nor income made a difference in high-risk oral infection rates, but rates among non-Hispanic blacks were higher than other races and ethnicities.

HPV vaccination is recommended starting at age 11 or 12 and is effective, said the senior author, Ashish A. Deshmukh, an assistant professor at the University of Florida, and “it’s crucial that parents vaccinate boys as well as girls.”

 

The lead author, Kalyani Sonawane, also at the University of Florida, said that behavioral change is important, too, particularly smoking cessation. “The difference in oral HPV infection between smokers and nonsmokers is staggering,” she said.

[Fundamental Law 2,885]

For those of us in the medical community, old news. We (personally) have two male colleagues, non smokers, who have developed squamous cancers of the oral cavity at a relatively young age. Both HPV positive in the cancer. This is a strong argument for administering the HPV vaccine to youth of both sexes as the article points out.

 

Oral sex is certainly a risk factor. However, if you have been pleasuring diverse women orally for a half century, you have surely been exposed many times. Get tested if you wish, but there is nothing actionable short of deciding to use a dental dam. There is no treatment for HPV carrier status.

[njbm 2,880]

Correct me if I am wrong, but I thought that there was no reliable test for HPV for men? Also, I understand that most Hpv infections are cleared by one’s system in 6-24 months and they do not typically lead to oral or cervical cancer. It’s not a good thing to have, but it does not invariably lead to cancer.

[PeterJ 954]

Get tested if you wish, but there is nothing actionable short of deciding to use a dental dam. There is no treatment for HPV carrier status.

 

My wife and I actually did try using a dental dam once. For me it was like licking a rubber ball. We never repeated that experiment.

[Fundamental Law 2,885]

Correct me if I am wrong, but I thought that there was no reliable test for HPV for men? Also, I understand that most Hpv infections are cleared by one’s system in 6-24 months and they do not typically lead to oral or cervical cancer. It’s not a good thing to have, but it does not invariably lead to cancer.

 

There is no ***approved*** test for HPV in men. The current test, which amplifies the HPV DNA, is both sensitive and specific. It is also blind to the origin of the swab. It does not care if you are male, female, or taken from a set of cells in culture.

 

Why is the test not approved? FDA approval is a complex process. It take money and time. For the latter, there has to be a health impact. For women, HPV testing complements (some would say "has all but replaced") Pap smears for screening for cervical cancer. That was worth the investment because it accelerated detection and treatment of a highly lethal cancer in stages early enough to remove the tissue at risk--up to and including hysterectomy. The situation is a bit different for men because the dotted line--carrier status to cancer patient is blurrier and further the appropriate treatment would be difficult until the precise location of the problem is identified.

 

By far the best approach at the moment is early vaccination of both sexes. It does not eliminate risk but it does mitigate risk.

 

Yes, most people do clear HPV infections over time. The common wart is also a manifestation of HPV infection. Many-- if not most -- people have had a wart eventually "go away".