Can You Get HPV From Oral Sex?

Famous actor, Michael Douglas, is in remission from having stage IV throat cancer that he at first admitted was due to the human papilloma virus, specifically HPV 16 and oral sex, but of late has recounted that statement stating his particular cancer was due to other reasons.  This has caused a lot of confusion for those wanting clearer answers on the risks associated with oral sex and the transmission of this aggressive virus.

There are several strains of HPV that can be transmitted from one person to another.  Some strains cause genital warts, some cause cervical abnormalities or cervical cancer while others, potentially in Michael Douglas’s case, cause throat cancer.  Most women associate this virus with abnormal pap smear results which is the reason for regular screenings.  It is reported that 50-80% of sexually active people have the HPV virus even with normal pap tests or no symptoms of warts.  The reason for this is that HPV is transmitted from skin-to-skin contact therefore actual intercourse does not have to occur to contract the virus nor does there have to be an exchange of fluids.  Therefore in throat cancer, transmission is through mouth and genital contact.

Throat cancer can be caused from other factors besides HPV such as tobacco (smoking and chewing), alcohol consumption, poor diet high in charred meat/red meat, and certain carcinogenic chemicals.  Symptoms often include a cough, pain in the throat, sensation of a lump in the throat, clearing the throat often, painful or sore tongue, change in voice (usually hoarse or lower voice), difficulty swallowing food or drink, and possibly bleeding in the throat or mouth that is ongoing for several weeks.  Diagnosis is typically done with a scope and biopsy.   Unlike HPV of the cervix which can affect a woman from their first sexual skin-to-skin experience, throat cancer is often diagnosed in those older than 50 and is more common in men.

So what can you do?  Be careful and be selective.  While hormone birth controls and the IUD protect against pregnancy, they do not protect against sexually transmitted infections, including HPV, therefore a barrier method is important.  Consider the HPV vaccine as HPV 16 (the more aggressive form and form often associated with throat cancer) is one of the strains it protects against.  Lastly, continue to have regular cervical screenings and talk with your healthcare provider about additional work up if you are experiencing any of the throat or mouth symptoms for an extended period of time.

References:

1.       Chusteka, Z. (2013).  HPV Oral Cancer: Low Risk for HPV Transmission.  Web.  16 June, 2013.

http://www.medscape.com/viewarticle/805422

2.       Pittman, G.  (2012).  HPV Tied to Throat Cancers.  Web. 16 June, 2013.

http://www.medscape.com/viewarticle/775491

3.       Mayo Clinic Staff.  (2012).  Throat Cancer. Web. 16 June, 2013.

http://www.mayoclinic.com/health/oral-and-throat-cancer/DS00349

4.       American Cancer Societ.  (2013).  Oral Cavity and Oropharyngeal Cancer.  Web.  16 June, 2013.

http://www.cancer.org/cancer/oralcavityandoropharyngealcancer/detailedguide/index

2013 Update: When Should You Get Your Pap?

The national pap guidelines seem to have changed a lot over the years with new guidelines debuting in 2009, some updates again in 2012 and now in 2013 it appears that some final decisions have been approved.  It used to be that a woman started having their pap smears in the teenage years and went yearly for the rest of her life.  While yearly physicals with her health care provider are important, a yearly pap is not necessarily required. 

According to most major women’s health and gynecology groups, a woman should have her first pap smear at 21 years of age.  This is different from 18 years old or age of first intercourse.  The younger a woman’s age, the healthier her immune system is therefore she is more likely to clear any abnormal cells caused by the human papilloma virus (HPV).  Additionally, if the results are normal, she is to have a pap test every 3 years.  Abnormal results may require more frequent follow up testing.

Once a woman turns 30 years old, the HPV test is added on to her pap smear as various factors, including age and immune system, may reduce her ability to clear the virus from her cervix.  If her pap smears continue to remain normal, she can continue with the ‘every 3 years’ recommendation.  If her results are abnormal, she again may require additional work-up and more frequent testing.

The new guidelines state that unless a woman has a history of a higher grade abnormal pap result, she can stop having pap smears at 65 years of age.  She should continue to have yearly physicals with her health care provider however.  Additionally, if a woman has had a total hysterectomy in which her cervix was also removed for non-cancerous reasons she does not need further pap smear testing however if she still has her cervix or if her hysterectomy was due to higher grade lesions or cancer, she will need to talk with her health care provider as she still needs some screening.

Remember that the purpose of pap smear screening is to evaluate the cells of the cervix for abnormal changes due to HPV and cervical cancer.  According to the Centers for Disease Control, cervical cancer used to be the most common cause of cancer death amongst women however with the increase in education and awareness for pap smear testing and HPV checks, the levels have greatly declined.  In fact in 2009, 12,357 women were diagnosed with cervical cancer and 3,909 died from it.  Therefore, if you have not had a pap smear test in the last 3 years or are not following up from an abnormal result, please do not be a statistic and make an appointment with your health care provider today.

For more information, read the women's health website Empowher, here!

References:

1.      Barclay, L.  (2013). Cervical Screening Guidelines Updated.  Web.  23 March, 2013.  http://www.medscape.com/viewarticle/781190

2.      Broder, J.  (2012). Pap Test Less Frequent Under New Guidelines.  Web. 23 March, 2013.

http://www.medscape.com/viewarticle/773282

3.      Centers for Disease Control (CDC).  (2012). Cervical Cancer Statistics.  Web. 23 March, 2013.

http://www.cdc.gov/cancer/cervical/statistics/

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