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Oral sex behaviors linked to HPV-related cancer risk

By Jeremy Booth, Dental Tribune International
January 25, 2021

BALTIMORE, U.S.: A study by researchers at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore has found that a wide range of oral sex behaviors may affect a person’s risk of infection with human papillomavirus (HPV) and his or her risk of developing the oropharyngeal cancers that are associated with the virus.

The university said in a press release that the majority of oropharyngeal cancers are related to HPV and that previous research has suggested that individuals with a greater number of oral sex partners face a higher risk of HPV-related oropharyngeal cancers. According to lead author Dr. Virginia Drake, a surgical resident at the Kimmel cancer center, the new study has added to an understanding of the additional risk factors related to oral sex that contribute to the disease.

Drake commented in the press release: “Although we know that HPV-related oropharyngeal cancer is strongly associated with oral sex and the number of oral sex partners, we haven’t really looked at what other behaviors might contribute to this disease.” She and her colleagues examined additional behavioral aspects by analyzing data from study participants who comprised 163 patients with HPV-associated oropharyngeal cancer and 345 healthy adults with similar demographic characteristics. Participants completed a detailed behavioral study on sexual behaviors which included the number of sexual partners, age of first sexual experiences, the type and order of sexual acts and the dynamics of their sexual partnerships. A blood sample was also submitted to test for antibodies to strains of the virus, and tumor samples were taken from the participants with cancer in order to confirm the presence of HPV.

The dynamics of sexual partnerships was also found to affect the risk of developing HPV-related cancers

When analyzing the data, the researchers confirmed that a higher number of oral sex partners correlated with an increased risk of HPV-associated cancers; however, they also found that a higher risk of HPV-related oropharyngeal cancers was related to oral sex acts undertaken at a younger age, to having a higher number of sex partners over a shorter time and to having oral sex before other kinds of sex.

The dynamics of sexual partnerships was also found to affect the risk of developing HPV-related cancers. “For example, a higher number of casual sex partners, extramarital sex and suspicion that a partner had extramarital sex also significantly raised the risk of HPV-associated oropharyngeal cancer, by more than 1.6 times. Having a sexual partner who was at least ten years older when the study participant was younger than age 23 was also associated with diagnosis of disease,” the university explained.

Drake said that the findings of the study add context to the behavioral connection between oral sex and tumors that occur in the mouth and throat. She said that the findings could also help to inform research on how the cancers develop and answer questions such as whether exposure to HPV at an older age, or initial exposure to genital HPV rather than oral HPV, could help to trigger a more robust immune response.

“Our biggest goal was to add context to what we already know about these cancers and gain a better understanding of the complex nature of this disease. This contemporary look into HPV-related oropharyngeal risk factors allows us to do just that,” Drake said.

The study, titled “Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer,” was published online on Jan. 11, 2021, in the journal Cancer, ahead of inclusion in an issue.

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