Oral sex feels good

Oral sex: risk of HPV infection

Vienna - Sometimes health policy measures can be read off pretty quickly from the number of sick people. For example when it comes to smoking. When smoking was banned in public buildings and restaurants in the United States, epidemiologists noticed pretty quickly because cancer numbers were falling rapidly. Specifically, the number of tumors of the head of the head has also decreased, because smoking is the most common cause of cancer on the tonsils, on the base of the tongue and in the throat, along with alcohol consumption.

"We were all the more astonished when the cancer numbers suddenly rose again and especially young people fell ill," remembers Wolfgang Gstöttner, head of the ENT clinic at Med-Uni Vienna. But the culprit was quickly found: It is the human papillomavirus (HPV), which can implant itself particularly well in the mucous membranes of the body exits.

HPV not only causes cervical cancer, it can also trigger tumors in the neck of the head. 30 to 40 percent of patients with tumors in the throat are HPV-positive. As a reminder: There are over a hundred different HPV strains, HPV-16, 18, 30 and 32 are particularly aggressive.

Failure of the immune system

In itself, the body's own defense system has the potential to fight off these viruses. That means: the viruses will also disappear again. Why this sometimes doesn't work is the subject of current research. What we know: Viruses, as non-independent organisms, need human cells in order to be able to multiply, "but HPV sometimes leads to a malignant transformation in the mucous membrane cells," says Gstöttner.

Oral sex is the main cause of infection, especially with "frequently changing sexual partners", according to Gstöttner. And specifies: "More than six a year." When HPV viruses from different organisms meet in the oropharynx, they appear to be particularly aggressive. The immune system is overwhelmed, according to Gstöttner's hypothesis.

The increasing number of neck tumors and changing sexual practices seem to be correlated with one another. US studies show that oral sex is a common form of sexual intercourse, especially in the US. "The differences in sexual behavior in the different age groups also explain the differences that we observe in the HPV infection and the tumors in the throat caused by HPV in the different generations - and above all why the cancer numbers are increasing," says Gypsyamber D ' Souza, who works at Johns Hopkins University in Baltimore on research into viral tumors.

Sexual fashions

In addition, it was announced at a meeting of the American Association for the Advancement of Science that men are not only more easily infected than women, but are also less likely to get rid of the infection, as the Washington Post rumored. However, there is still no definitive evidence as to why HPV in the throat is more aggressive in men than in women.

"Possibly also because many young women are meanwhile also vaccinated against HPV and thus protected", suspects Wolfgang Gstöttner. The expert is in favor of an HPV vaccination for boys too, because he experiences again and again how much his HPV-positive patients regret not having used this disease prevention option. Once the virus is in the body, vaccination no longer makes sense - at least the scientific evidence for it is missing.

The good news: tumors caused by HPV are relatively treatable, especially if the cancer is located in such a way that it can be removed. Throat tumors metastasize relatively quickly in the throat. With radiation and chemotherapy, the chances of recovery are relatively good compared to other types of cancer. Early detection is also crucial in ENT oncology.

Anyone who has oral intercourse with different partners more than six times a year, does not use condoms and feels a strange feeling in the throat that lasts for weeks should be clarified. "Safer sex or sex with a fixed partner are also an option for avoiding HPV infection," adds Gstöttner, who, however, has a neutral view of oral sex from a medical point of view. (Karin Pollack, January 25, 2017)

Original study

Sex Differences in Risk Factors and Natural History of Oral Human Papillomavirus Infection

For further reading

Decision support for or against HPV vaccination

New vaccine protects 90 percent against cervical cancer

There is a revival of STDs