Over the last two decades there has been a rapid increase in throat cancer in the West, to the point that some have called it an epidemic. This has been due to a large increase in a specific type of throat cancer called oropharyngeal cancerwhich affects the area of the tonsils and the back of the throat.
Its main cause is human papilloma viruso (HPV), which is also behind many cases of cervical cancer. Currently, oropharyngeal cancer is more common than cervical cancer in the United States and the United Kingdom.
In Spain, the oropharyngeal cancer It is among the ten most diagnosed, with about 8,000 new cases per year. And in Central and South America it is an increasingly serious problem, to the point that an increase of 17.2 percent in oral cancer mortality is expected by 2030.
HPV is transmitted sexually. In the case of oropharyngeal cancer, the main risk factor is the number of sexual partners throughout life, especially due to the practice of oral sex. People with six or more sexual partners oral sex throughout their lives are 8.5 times more likely to develop oropharyngeal cancer than those who do not practice oral sex.
80% of adults practice oral sex
Studies on behavioral trends show that oral sex is widespread in some countries. In a study of nearly a thousand people who underwent tonsillectomy for non-oncological reasons in the United Kingdom, 80 percent of adults reported having practiced oral sex at some point in their lives. Fortunately, however, only a small number of those people develop oropharyngeal cancer.
Although it is still not entirely clear what it depends on, the prevailing theory is that most people get infections from HPV and they are able to eliminate them completely. However, a small number of people are not able to get rid of the infection, perhaps due to a defect in a particular aspect of their immune system. In such patients, the virus is capable of continuous replication and, over time, integrates into random positions in the host’s DNA, some of which can cause the host’s cells to become cancerous.
HPV vaccination of young women has been introduced in many countries to prevent cervical cancer. There is now increasing evidence, although still indirect evidence, that it may also be effective in preventing HPV infection in the mouth.
There is also evidence to suggest that boys are protected by “herd immunity” in countries where vaccine coverage for girls is high (more than 85 percent). It is expected that in a few decades the increase in protection will lead to a reduction in oropharyngeal cancer.
That’s all very well from a public health standpoint, but only if coverage among girls is high, above 85 percent, and only if one remains within the protected “herd.” However, it does not guarantee protection at the individual level – and especially in these times of international travel – if, for example, someone has sex with people from countries with low coverage. And it certainly offers no protection in countries where vaccination coverage for girls is low, for example, the United States, where only 54.3 percent of adolescent girls ages 13 to 15 had received two or three doses of the vaccine. HPV in 2020.
HPV vaccination should also be for men
This has led several countries, including the UK, Australia, and the US, to expand their national HPV vaccination recommendations to include young men, applying a gender-neutral vaccination policy.
But having a universal vaccination policy does not guarantee coverage. HPV vaccination is opposed by a significant proportion of some populations due to concerns about safety, necessity, or, in some less common cases, the encouragement of promiscuity.
Paradoxically, there is some evidence from population studies that, possibly in an effort to abstain from penetrative sex, young adults may engage in penetrative sex instead. oral sex, at least at the beginning. Without being aware that this also poses a risk.
Written by Hisham MehannaProfessor at the Institute of Cancer and Genomic Sciences at the University of Birmingham in the United Kingdom.
The Conversation is an independent, nonprofit source of news, analysis, and commentary from academic experts.
2023-05-03 23:13:00
#Human #papillomavirus #HPV #main #risk #factor #throat #cancer
