What is human papilloma virus (HPV)?

HPV is a sexually transmitted virus. There are more than 40 subtypes of HPV that can infect the genital area and the throat (tonsillar HPV).

How common is human papilloma virus (HPV) infection of the throat?

A recent study found that 7% of Americans 14 to 69 years old are infected with tonsillar HPV. The same study found that the prevalence has increased significantly over the past 3 decades, and that more men than women have oral HPV infection.

The most frequent subtype of tonsillar HPV detected is HPV-16, a high-risk subtype of HPV for oropharyngeal (mouth and pharynx) cancer. About 2/3 of oropharyngeal cancers have HPV DNA in them. Infection with HPV-16 occurs in about 1% of men and women.

How is oral human papilloma virus (HPV) acquired?

Evidence strongly suggests that tonsillar HPV is predominantly transmitted by sexual contact. An increase in oral sex is suspected as the cause of the increase in the prevalence of tonsillar HPV infection, although several sexual behaviors seem to be related to oral HPV prevalence. The risk of infection increases with an increasing number of lifetime or recent sexual partners for any type of sexual behavior (ie, vaginal sex, oral sex). With 20 or more lifetime sexual partners, the prevalence of oral HPV infection reaches 20%. Smokers are also at greater risk than nonsmokers, with current heavy smokers at particularly high risk.

What are the signs and symptoms of human papilloma virus (HPV) infection?

Most people with oral HPV infections have no symptoms and therefore do not realize that they are infected and can transmit the virus to a partner.

What are the consequences of tonsillar human papilloma virus (HPV) infection?

Tonsillar HPV infection can cause oropharyngeal cancer. An increase in the incidence of oropharyngeal cancer has paralleled the increased prevalence of tonsillar HPV infection. However, the vast majority of people with tonsillar HPV infections do not develop cancer because the subtypes of HPV with which they are infected are not linked to development of cancer. Although millions of Americans have tonsillar HPV, fewer than 15,000 get HPV-positive oropharyngeal cancers annually.

Many oropharyngeal cancers are not related to HPV infection, but rather with tobacco and alcohol use. People with HPV-positive oropharyngeal cancers tend to be younger and are less likely to be smokers and drinkers.

Are there any signs that are specific for human papilloma virus (HPV)-positive oral cancer?

The first sign is often having trouble with swallowing. Other signs are:

  • Coughing up blood
  • A lump on the neck or in the cheek, or
  • Hoarseness that doesn’t go away

Unfortunately, these are late signs of the disease.

Other potential signs and symptoms of oral cancers are:

  • Sore throat
  • A white or red patch on the tonsils
  • Jaw pain or swelling, and
  • Numbness of the tongue, among others

These signs don’t necessarily mean that you have cancer, but if any signs are present for longer than 2 weeks, you should see your doctor.