More young adults have developed oropharyngeal squamous cell carcinoma (OPSCC) within the last four decades than in the previous 100 years combined, and the human papillomavirus may be to blame, according to new research.
Between 1973 and 2009, oropharyngeal squamous cell carcinoma - a type of cancer that forms in the middle part of the throat and includes the back of the tongue, the soft palate, and the tonsils - increased by 60 percent among people younger than age 45 in the U.S., according to researchers at Detroit's Henry Ford Health System and the Wayne State University Karmanos Cancer Institute.
The HPV link
Scientists said that a leading suspect of the rise in oral cancer is human papillomavirus, more commonly known as HPV, which is a viral infection spread through skin to skin contact, usually during sexual encounters. HPV plays a role in OPSCC by spurring abnormal tissue growth, such as warts and other infected changes to cells. Currently, according to the Centers for Disease Control and Prevention, HPV is the most common sexually transmitted infection in the U.S.
Earlier studies have indicated a possible link between HPV and poor oral health. Swollen gums, tooth decay and bad breath are all signs of a dirty mouth. Though the association requires further scientific evidence, it does lead to some concerns. People with poor oral hygiene are more susceptible to lesions, canker sores or bleeding gums, which provide an entry point for the virus to enter the body.
In the research from the Henry Ford Health System, there was a noteworthy difference between races and genders when it came to oral cancer. Caucasians showed a 113 percent increase within the last 40 years, while African-Americans had a 52 percent decline during that time period. Despite this reduction, the five-year survival rate remains worse for African-Americans. Rates more than doubled for men but remained consistent for women.
"We were interested in looking at people born during that time period and incidence of oropharyngeal cancer," lead author Dr. Farzan Siddiqui, director of the Head & Neck Radiation Therapy Program in the Department of Radiation Oncology at Henry Ford Hospital, told the Henry Ford Health System. "Not only were we surprised to find a substantial increase in young adults with cancer of the tonsils and base of tongue, but also a wide deviation among Caucasians and African Americans with this cancer."
Researchers analyzed 1,603 adults younger than age 45 who had been diagnosed with OPSCC between 1973 and 2009. Because the data did not include the patients' HPV status, tumor grade was used as a surrogate indicator of HPV infection. Nearly 90 percent of the subjects were ages 36 to 44, and the majority of them were white.
"The growing incidence in oropharyngeal cancer has been largely attributed to the sexual revolution of the 1960s and 1970s, which led to an increased transmission of high-risk HPV," Siddiqui explained to the source.
Most people who become infected with HPV do not know they have it. This specific type of infection is passed through genital contact to the mouth area, generally during oral sex. Similar to herpes and other STIs, HPV can spread when the infected partner shows no symptoms.
Dr. Siddiqui pointed out that the prevalence of oropharyngeal cancer in this age group suggests either a shortened latency period between infection and development of cancer or non-sexual modes of HPV transfer at a younger age.
While many doctors are looking at HPV as a main cause, the use of tobacco products and drinking too much alcohol can also increase the risk of oropharyngeal cancer. Other risk factors include a diet low in fruits and vegetables, drinking maté, a stimulant drink common in South America, and chewing betel quid, a stimulant commonly used in parts of Asia.
To protect yourself against HPV and possibly oral cancers, be sure to practice safe sex and maintain a good oral hygiene regimen. Visiting a dentist for routine check-ups, brushing your teeth twice a day and using alcohol-free mouthwash for bad breath, germs and canker sores may help reduce your risk for infection.