When Michael Douglas intimated that cunnilingus caused throat cancer in an interview with the Guardian earlier this summer, America blushed and shimmied around with her knickers in a twist. Amid rabid speculations about Catharine Zeta Jones’s HPV-status, Douglas eventually had to deny–or clarify, in his words–that his throat cancer did not come from oral sex (and, by extension, Zeta-Jones’s or his ex-wife’s vagina). “Oh, okay,” America said, then went back to talking about Edward Snowden.
The conversation should have continued, especially as new research from Canada reaffirms the link–and the growing concern–that the consequences of HPV range more widely than previously thought. In this month’s issue of Current Oncology, a team of Canadian researchers found proof that HPV-related throat cancer is increasing in the Canadian population, specifically in men. Out of 160 tumor samples taken from the back of the throat and tongue, the team found that 57% screened positive for bits of HPV DNA.
The study followed up on research done in the United States in 2011 that showed that HPV-related throat cancer increased from 16.3% of tumors in the ‘80s to more than 70% of tumors in the early 2000s. The Canadian study saw a similar pattern. In the ‘90s, Canadians measured the prevalence of HPV-related cancer at 25% of throat cancers, which jumped to 62% between 2006 and 2011.
“The link between HPV and cancer is unquestionable now,” Dr. Anthony Nichols, director of Translational Head and Neck Cancer Research in the London Regional Cancer Program, says. “It clearly causes cervical cancer, it clearly plays a role in throat cancer, and penile cancer and anal cancers. It’s sexually transmitted, obviously. And the strongest link is specifically oral sex.”
Nichols and his colleagues are not warring against oral sex. In fact, some of the moralistic fuss around teenage sex and the HPV vaccine are likely helping the virus spread. “In Ontario, because [the HPV vaccine] is only provided for girls, kids will sometimes make fun of them, calling them the ‘sex’ girls,” Nichols explains. Some parents fear that vaccinating their kids for HPV gives them a get-out-of-jail-free card for irresponsible kinds of sexual exploration. Meanwhile, the Catholic Diocese of Toronto has spoken out openly against the vaccine. “Studies have been done that [the vaccine] does not make girls promiscuous,” Nichols says. “In addition to the regular barriers to vaccination, there’s now this extra social component, and that’s why this vaccine uptake–even though it’s 50% or 60%–is low.”
In an atmosphere where girls are shamed for getting the vaccine, and boys can run around transmitting it without even knowing, Nichols argues it’s imperative to spread awareness of HPV’s long-lasting consequences. He notes that we’re likely seeing the increase in HPV-related cancers now because there appears to be a 30-year gap in between when men get infected and when they develop throat cancer–and it’s possible that the rising epidemic of throat cancers we see today can likely be tied to the sexual revolution of the ‘70s. “With rates of increasing STDs, and the fact that there seems to be a 30-year lag time between when you get infected and when throat cancers show up, it could be a real problem for the foreseeable future,” Nichols says.
CDC data show that vaccine coverage for HPV is increasing slowly, but still lags far behind other vaccinations, indicating that girls aren’t getting the vaccine between the recommended ages of 11 and 12. In 2011, just 35% of teenage girls went through all three doses of the HPV vaccine. The CDC also notes that southern states–some of which also have the worst records on facilitating women’s access to health care–have the lowest rates of HPV vaccinations as well as higher rates of cervical cancer.
In Canada, the HPV vaccine is approved for both adolescent boys and girls, but only subsidized for girls. In the U.S., two HPV vaccines exist, but only one is approved for both boys and girls. “There’s an argument that vaccinations work best if the whole population is immunized,” Nichols says. “Boys are part of the transmission process from girl to boy to girl–they should be part of that, too.”