Oral HPV Is a Developing Concern in Men

HPV infection

1 in 9 American men is plaque with oral human papillomavirus (HPV). This make them susceptible to a long list of sexually transmitted infections.

The human papillomavirus (HPV), a group of more than 150 related viruses, can plaque both men and women.

Some types of HPV can cause common skin warts, some can cause genital warts, and some may cause certain types of cancer.

Of optimal concern for men in the United States is the rise in the number of cases of oropharyngeal cancer linked to HPV infection in recent years. Oropharyngeal cancer is cancer that develops on the back and sides of the throat, tonsils, and base of the tongue.

Though it is not known why the incidence of this type of cancer is rising, it’s believed to be the result of more people engaging in sexual activity with more partners than in years past, added with an increase in oral sex practices. Consequently, more people have oral HPV infections, which put them at risk. (1)

Heavy tobacco and alcohol use also raise the risk of oropharyngeal cancer, but they do not appear to be the cause of the upward trend in cases.

Currently in the US alone, an estimated 11 million men have an oral HPV infection, according to a research paper published in November 2017 in the Annals of Internal Medicine. In contrast, 3.2 million American women have an oral HPV infection. (2)

Not all oral HPV infections lead to cancer, but the American Cancer Society estimates that about 51,540 people will get oral cavity or oropharyngeal cancer in 2018 and about 10,000 will die from it. (3)

Oral cavity and oropharyngeal cancers are twice as common in men as in women. They are diagnosed most frequently in people ages 55 to 64. (4)

With that said, the lifetime risk of developing oropharyngeal cancer, even among men whose oral cavity is infected with a cancer-causing strain of HPV, is considered low. (5)

Signs and Symptoms of HPV-Related Oropharyngeal Cancer in Men

In investigative studies, oral HPV infections are found by having study subjects rinse and gargle with a solution that is then examined for the presence of HPV.

But because such tests are not done routinely by doctors or dentists, oropharyngeal cancers caused by HPV are generally discovered when they cause symptoms.

Signs and symptoms of oropharyngeal cancer include:

  • Persistent sore throat, hoarseness, or coughing
  • Persistent ear pain
  • Pain while chewing or swallowing
  • Weight loss
  • A lump in the neck
  • Difficulty opening the mouth fully
  • Change in voice

According to the American Cancer Society, getting regular dental checkups that include an exam of the entire mouth is one way to find oral and oropharyngeal cancers (and precancers) early.

Genital HPV Infection in Men

American men have even higher rates of genital HPV infection than they do oral HPV.

According to an April 2017 report from the National Center for Health Statistics, during 2013 and 2014, the prevalence of any genital HPV infection among U.S. adults ages 18 to 59 was 42.5 percent. Among men the prevalence was 45.2 percent, and among women, 39.9 percent. (6)

More than 40 types of HPV are transmitted through direct sexual contact, including vaginal, anal, and oral sex.

Men who have sex with men and those with weakened immune systems, including from HIV, are most likely to contract HPV.

Genital HPV infection in men is responsible for 63 percent of penile cancers and 91 percent of anal cancers, according to an investigation published in June 2017 in JAMA Oncology. (7)

Genital HPV infection can also cause genital warts, with HPV types 6 and 11 responsible for 90 percent of genital warts. Those same types of HPV can also cause a condition called recurrent respiratory papillomatosis, a rare but life-threatening disease in which warts form in the respiratory tract, potentially blocking the airway. (8)

Signs/Symptoms of Penile and Anal Cancers

Penile cancer initially causes tissue changes in the penis — including changes in color and skin thickening — but may later cause penile growths or sores.

Signs of anal cancer include anal bleeding, pain, itching, or discharge; swollen lymph nodes in the anal or genital area; and changes in bowel habits and stool.

If you notice any of these signs or symptoms, consult your doctor.

Anal, penile, and oropharyngeal cancers caused by HPV are treated with standard cancer therapies, including chemotherapy, radiation therapy, and surgery.

Symptoms of Genital Warts in Men

For men, genital warts — which may show up weeks to months after HPV is contracted — grow inside or around the anus, on the upper thighs and in the groin area, and on the scrotum and penis, including under the foreskin and inside the urethral opening. (The urethra is the tube through which urine exits the body.)

Genital warts may be:

  • Clearly visible or too small to see
  • Flat or raised
  • Cauliflower-like in appearance (when they grow in clusters)
  • Tender, painful, or itchy

If warts grow in the urethral opening, they can cause abnormal urine flow as well as bleeding from the urethra.

Genital warts can be treated with several self-applied or doctor-applied topical medications. Surgical treatment may be required for difficult-to-treat warts.

Preventing the Spread of HPV in Men

The best way to prevent genital warts and HPV-related cancers in men is with the HPV vaccine.

Gardasil 9, the HPV vaccine is readily available in the US, it protects against HPV types 16, 18, 31, 33, 45, 52, and 58, all of which can give way to cancer, as well as types 6 and 11, which cause genital warts.

It is almost 100 percent effective at preventing against infection with these types of HPV.

The CDC advices that all boys (and girls) get the HPV vaccine at age 11 or 12. The vaccine is also approved for:

  • Boys as young as age 9 if they have a history of sexual abuse
  • Boys and men through age 45 if they aren’t already vaccinated
  • Men who have sex with men, and men with weakened immune systems, through age 26

For men of all ages, cutting the number of sexual partners can reduce exposure to HPV, and using condoms or dental dams during sex is partially protective against HPV infection.

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