So, not too long ago, I posted about how HPV is now the leading cause of oral cancers, primarily due to a drop in smoking making tobacco use a decreasing cause of cancer. But this sort of implies that the total number of oral cancers is more or less stable and only the causes have shifted.
Well, a Swedish study says otherwise.
This is merely a preliminary study and more research with larger sample populations needs to be done, but it's implications are frightening.
Not only is HPV the leading cause of oral cancers, but oral cancers in general are on the rise in spite of tobacco use declining. This means that the rate of HPV infections of oral tissue is even faster that we thought.
None of my research so far has given me hard and fast numbers as to the probability of catching HPV orally, which activities transmit it, nor how often that oral infection turns into cancer. I can only get vague words like "low risk" or "moderate risk", which are highly subjective words. Just how easy is it to catch HPV in oral tissue? And does it transfer by giving oral sex to someone with HPV on their genitals or can it transfer by kissing too? This information is just not readily available in the journals I have access to.
But, according to a study done in Stockholm, which they admit limits their results to Stockholm residents but claim that Stockholm is a representative city for Europe in general, the number of tonsil cancers caused by HPV in 1970 were only 23%, but the number of tonsil cancers caused by HPV today are a whopping 93%. This makes HPV as the cause of tonsil cancer just as prevalent as HPV being the cause of cervical cancer. And since tonsil cancer is on the rise in general, that makes for a shit-load of HPV-caused oral cancer.
This is not a woman's disease. Because there is no regular screening in place for oral cancer, most oral cancers are not diagnosed until they are already well advanced, which lowers the survival rate. And, the average age of HPV-postive tonsil cancer victims is ten years younger than those with HPV-negative cancer. The good news is, however, that the cancers caused by HPV have a better prognosis than HPV-negative tonsil cancer patients. According to this study, 81% of HPV-postive cancer patients have a 5-year survival rate, as opposed to 36% of the HPV-negative patients.
Once again, this article does not make any mention at all about how the HPV is transmitted to the oral tissue, or how easily. It also doesn't say how common tonsil cancer is in general, so it could be that HPV-positive cancer is on the rise but only .01% of the general population gets it. Personally, I'm inclined to believe (lacking any other data) that the rate of cancer from HPV in oral tissue is probably similar to the rate of cancer forming from HPV in genital tissue. So until I see contradictory data, that's the hypothesis I'm running with. Which means that the majority of HPV infections probably do not turn into cancer, but the number of infections that do is similar to the number of women who get cervical cancer from HPV.
But for those who have it, it's small consolation to tell them "well, you were statistically unlikely to get this, so sorry".
Fortunately, Gardasil, the vaccine, protects against the only strain this article mentioned, which is HPV-16. Gardasil is also showing signs of protecting against 10 other strains that it was not specifically designed to protect against. Apparently those other strains have something in common with the 4 included in the vaccine, that the vaccine is somewhat effective against them too. This article even specifically claims that they expect to see a decline in oral cancers following the rise of vaccinations.
And, there is finally talk about vaccinating boys. My inbox has been flooded with articles about this issue for the past week or two, but I haven't written about it because I get too pissed off every time I start. Many feminists and those of an egalitarian mindset have made not-really-jokes that if men had to get pregnant, we wouldn't have this whole debate about abortions - they'd be legal and cheap and easy and only a small minority of people would be shouting about "life is sacred".
Well, the double standard certainly seems true in the vaccine debate. The debate over giving Gardasil to boys is heated, and revolving around the efficacy of the vaccine, but no one anywhere seems to be concerned that this vaccine will make boys more promiscuous. No one has made that complaint, no one is calling for a protection of boys' virtue, nothing. The debate is based on the evidence of whether or not the vaccine is effective enough to be worth the cost, just as the debate should.
So, since I've already posted that trials have begun over giving the vaccine to boys, I haven't posted much about the debate itself, because it's not really much of an STD issue - at least, not any more than I've already said about the vaccine with regards to girls, the same issues apply. I haven't posted because it's more of a gender issue, and I'm just so fed up with defending equal treatment for both genders that I can't quite stomach even getting into another rant about it.
So, the bottom line for this post is that HPV is proving to be a rising danger for both men and women, and for health issues other than cervical cancer. The days of "well, the odds are that you'll get it eventually, so just don't worry about it" are coming to a close as we learn that more and more cases of cancer are caused by this once-thought "harmless", "easily-treatable", and "woman's issue" virus, and more and more medical researchers are pushing for better screening processes and proactive treatments like the vaccines.
It's about time someone started listening. I've been yelling about this for about 15 years and everyone looks at me like "dude, what's the big deal? So you get warts, that's just annoying. So you get a virus, it doesn't *always* turn into cancer so relax. And besides, it won't hurt me, I'm a guy". It's certainly not an automatic death sentence, the vast majority of people survive this virus. But it is also most certainly not "not a big deal".
****EDIT****
http://news.myjoyonline.com/health/200904/28521.asp
As someone pointed out, the above article talks about a pretty small study, so here's another one. This was done by John Hopkins University on about 300 people that seems to suggest that HPV is a "much stronger risk factor than tobacco or alcohol use". Those who had HPV in the past had a 32-fold increased risk of throat cancer.
A strange factoid is that smoking and alcohol are not additional risks, "suggesting that the virus itself is driving the cancer".
This article is unique in that it explicitly addresses the question of how HPV is transmitted, although it is still vague and doesn't give any hard statistics. They know that oral sex is the "main mode of transmission", but this article specifically states that transmission from oral-to-oral (i.e. kissing) is unknown, but could not be ruled out. Great.
This article also points out that it is unknown how well the vaccines prevent oral cancers, since they were specifically tested for cervical cancer, but the researchers still recommend that girls and boys get the vaccine. This article also points out that this type of throat cancer is extremely rare.