The ABCs of HPV
Most people know that human papillomavirus (HPV) causes cervical cancer. But HPV is also behind other types of the disease, including cancers of the vulva, penis, and anus. One type has surpassed even cervical cancer as the most common: HPV-associated cancer of the oropharynx, or throat.
“The vast majority of people have no idea that HPV causes this subset of cancers,” says Daniel Faden, MD, a head and neck cancer surgeon at Massachusetts Eye and Ear. Even some doctors don’t realize it, he says.
“If you look at the trends, cervical cancer rates continue to go down due to effective screening,” Faden adds. “Oropharyngeal cancers, on the other hand, are rising at epidemic proportions.”
HPV-related oropharyngeal cancers occur in a specific area of the throat: in the tonsils and at the base of the tongue, the part people can’t see or touch. They are a subset of squamous cell carcinoma, the most common form of cancer in the head and neck, says Jennifer Cracchiolo, MD, a head and neck cancer surgeon at Memorial Sloan Kettering Cancer Center. The most common risk factor for these cancers used to be alcohol and tobacco use, but now 70% to 90% are caused by HPV.
According to the CDC, between 1999 and 2015, cervical cancer rates decreased 1.6% per year, but oropharyngeal cancer rates rose 2.7% per year among men and 0.8% per year among women. These cancers are also increasingly diagnosed in younger people, many in their forties or fifties.
Current data shows that the HPV vaccine has led to a significant decrease in the number of young women with HPV and HPV-associated cervical precancers, including unvaccinated women who likely benefit from herd immunity. It’s projected that the vaccine will lead to a similar reduction in oropharyngeal cancers. But the vaccine is just over a decade old. Since most people are diagnosed with oropharyngeal cancer in their 50s or later, people at risk of developing these cancers in the near future have likely not been vaccinated.
Because it is most effective when administered before a person becomes sexually active, the U.S. Food and Drug Administration (FDA) recommends routine vaccination for 11- and 12-year-olds. First approved for girls in…