Oral sex is now the leading risk factor for throat cancer, surpassing smoking and drinking in some countries. This alarming trend has been linked to the human papillomavirus (HPV), which is also the main cause of cervical cancer. In the US and the UK, oropharyngeal cancer – the type that affects the tonsils and back of the throat – has become more prevalent than cervical cancer. According to a study, addressed in The Conversation, 80 per cent of adults in UK who underwent tonsillectomy for non-cancer reasons had practised oral sex at some point in their lives. However, only a small number of those people develop oropharyngeal cancer, as most people are able to clear HPV infections completely.
The good news is that HPV vaccination for young girls has been implemented in many countries to prevent cervical cancer. There is increasing evidence that it may also be effective in preventing HPV infection in the mouth. Several countries, including the UK, Australia, and the US, have also extended their national recommendations for HPV vaccination to include young boys.
“There is also some evidence to suggest that boys are also protected by “herd immunity” in countries where there is high vaccine coverage in girls (over 85 per cent). Taken together, this may hopefully lead in a few decades to the reduction of oropharyngeal cancer,” reported the study. It added, “That is well and good from a public health point of view, but only if coverage among girls is high – over 85 per cent, and only if one remains within the covered ‘herd’.”
However, universal vaccination policies do not guarantee coverage, as there is a significant proportion of some populations who are opposed to HPV vaccination. This, coupled with the increasing trend of vaccine hesitancy, may contribute to a reduction in vaccine uptake. The study also mentioned interestingly, research conducted on populations shows that young adults may engage in oral sex as a substitute for vaginal intercourse, possibly as a way to avoid it.
As always, dealing with populations and behaviour is complex. The pandemic has brought its own challenges, with young people unable to access vaccinations at schools for a period of time. But with continued efforts to increase awareness and improve vaccine uptake, hopefully, we can reduce the incidence of oropharyngeal cancer in the future.
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