HPV and Oropharyngeal Cancer

Human papillomavirus (HPV) can cause serious health problems, including genital warts and certain cancers. However, in most cases HPV goes away on its own before causing any health problems.

What is genital HPV?

Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection in the United States. Most types of HPV are not harmful to people. Most people who become infected with HPV do not know that they are infected.

More than 40 types of HPV can infect the genital areas. Some types are known as cancer-causing types. HPV 16 and 18 are the two most common cancer-causing types. In the United States, HPV type 16 causes about half of cervical cancers, and types 16 and 18 together account for about 70% of cervical cancers. Infection with a cancer-causing HPV type is considered necessary to get cervical cancer, but the vast majority of people with an HPV infection do not get cancer.

What is oral HPV?

The same types of HPV that infect the genital areas can infect the mouth and throat. HPV found in the mouth and throat is called oral HPV. Some types of oral HPV, known as cancer-causing types, can cause cancers of the oropharynx (back of the throat, including the base of the tongue and tonsils). Other types of oral HPV, known as non-cancer-causing types, can cause warts in the mouth or throat. In most cases, HPV infections of all types go away before they cause any health problems.

What are head and neck cancers?

Head and neck cancers are cancers that start in the tissues and organs of the head and neck. They include cancers of the larynx (voice box), throat, lips, mouth, nose, and salivary glands.

Tobacco use, heavy alcohol use, and infection with HPV increase the risk of many types of head and neck cancer. HPV increases the risk of only certain types of head and neck cancers.

Which head and neck cancers can be caused by HPV?

HPV can cause cancers in the oropharynx. These cancers are called oropharyngeal cancers. Most, but not all, oropharyngeal cancers are caused by HPV. HPV is thought to cause 70% of oropharyngeal cancers in the United States, with HPV type 16 causing 60% of all oropharyngeal cancers. HPV is not considered a cause of cancers in the mouth, larynx, lip, nose, or salivary glands.

How does HPV cause cancer?

HPV can cause normal cells in infected skin to turn abnormal. Most of the time, you cannot see or feel these cell changes. In most cases, the body fights off the HPV infection naturally and infected cells go back to normal. But in cases when the body does not fight off this virus, HPV can cause visible changes, and certain types of HPV can cause oropharyngeal cancer.

Cancer caused by HPV often takes years to develop after getting an HPV infection. It is unclear if having HPV alone is enough to cause oropharyngeal cancers, or if other factors (such as smoking or chewing tobacco) interact with HPV to cause these cancers. More research is needed to understand all of the factors leading to oropharyngeal cancers.

What are the signs and symptoms of oropharyngeal cancer?

Signs and symptoms may include persistent sore throat, earaches, hoarseness, enlarged lymph nodes, pain when swallowing, and unexplained weight loss. Some people have no signs or symptoms.

How common is oral HPV?

Studies have found that about 7% of people in the United States have oral HPV, but only 1% of people have the type of oral HPV that is found in oropharyngeal cancers (HPV type 16). Oral HPV is about three times more common in men than in women.

How common are cancers of the oropharynx?

Each year, about 11,600 people in the United States are diagnosed with cancers of the oropharynx that may be caused by HPV. Cancers of the oropharynx are about four times more common in men than women.

How do people get HPV?

People get HPV from another person during intimate sexual contact. Most of the time, people get HPV from having vaginal or anal sex. Men and women can also get HPV from having oral sex or other sex play. Although some studies suggest that oral HPV may be passed on during oral sex (from mouth-to-genital or mouth-to-anus contact) or open-mouthed (“French”) kissing, the likelihood of getting HPV from kissing or having oral sex with someone who has HPV is not known. We do know that partners who have been together a long time tend to share genital HPV—meaning they both may have it. More research is needed to understand exactly how people get and give oral HPV infections.

How can I lower my risk of giving or getting oral HPV?

At this time, no studies have explored how oral HPV can be prevented. However, it is likely that condoms and dental dams, when used consistently and correctly, will lower the chances of giving or getting oral HPV during oral sex because they can stop the transmission of HPV from person to person. The HPV vaccine also could prevent oropharyngeal cancers; please see more information below. More research is needed to understand how oral HPV is passed on, how it can be prevented, and who is most likely to develop health problems from an oral HPV infection.

Is there a test for me to find out if I have oral HPV?

No test is approved by the U.S. Food and Drug Administration (FDA) to diagnose HPV in the mouth or throat. Medical and dental organizations do not recommend screening for oral HPV. More research is needed to find out if screening for oropharyngeal cancers has health benefits. Talk to your dentist or other health care provider about any symptoms that could suggest early signs of oropharyngeal cancer.

Can the HPV vaccine prevent oral HPV and oropharyngeal cancers?

The HPV vaccine was developed to prevent cervical and other less-common genital cancers and was shown in studies to prevent cervical and other precancers. The HPV vaccine also could prevent oropharyngeal cancers because the vaccine prevents infection with HPV types that can cause oropharyngeal cancers, but studies have not been done to show if the HPV vaccine prevents oropharyngeal cancers.

CDC recommends 11- to 12-year-old boys and girls get two doses of HPV vaccine to protect against cancers caused by HPV. The second dose should be given 6 to 12 months after the first dose.

CDC also recommends that girls and women through age 26 years and boys and men through age 21 years get the vaccine if they did not get vaccinated when they were age 11 or 12 years. The number of recommended doses depends on the age at vaccination.