A new study suggests human papillomavirus (HPV) could be behind a rise in oropharyngeal (head and neck) squamous cell cancer cases in the United States and in some northern European countries, and that changing sexual behaviors could be the reason.

Citing previous research and using the Swedish Cancer Registry, Torbjorn Ramqvist and Tina Dalianis of the Karolinska Institutet in Stockholm noted that oral sex has become more commonplace; people report more sex partners; and the age of sexual debut has decreased -- all of which are linked to HPV-related oral cancers. "In a recent study ... it was shown that the risk of developing oral HPV infection increased with increases in lifetime oral or vaginal sex partners," they said. "It has also been reported that ... open-mouthed kissing was associated with the development of oral HPV infection," they said, citing a study of 542 U.S. students.

"We suggest that we are encountering a slow epidemic of mainly sexually transmitted HPV-induced" oral cancers, the authors said.

Oropharyngeal cancers are the second-most common cancer linked to HPV, behind cervical cancer. The authors observed that cases of throat and mouth cancer are rising in the United States, the United Kingdom, Finland, the Netherlands, and Sweden, particularly among young people. Cases are more common among men than women, they noted.

Researchers next must examine the effects of the HPV vaccine on oropharyngeal squamous cell cancers. If the vaccine is effective at preventing head and neck cancers, health officials should consider expanding vaccination from the current focus on females to include males as well, the authors suggested.

The study, "Oropharyngeal Cancer Epidemic and Human Papillomavirus," was published in CDC's Emerging Infectious Diseases (2010;16(11)doi:10.3201/eid1611.100452).

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