NEWPORT BEACH, CA — A serious change in the cause of oral cancer is taking place nationally, and its implications are impacting the American public in a manner that a decade ago no one would have predicted.
For decades, oral cancer (also known as mouth cancer, tongue cancer, tonsil cancer, and throat cancer) has been a disease which most often occurred in older individuals, who during their lifetimes had been tobacco users. Most cases were ultimately the result of lifestyle choices. Today that paradigm has changed. A common, sexually transferred virus has replaced tobacco as the number one cause of oral cancers, Human Papilloma Virus number 16 (HPV16). This is one of the same viruses that are responsible for the majority of cervical cancers in women.
This year alone, approximately 37,000 Americans will be newly diagnosed with oral cancer, and one person will die every hour of every day from this disease. HPV16, one of about 130 versions of the virus, is now the leading cause of oral cancer, and is found in about 60% of newly diagnosed patients. Dr. Maura Gillison from the James Cancer Center, a long time researcher of the relationship between HPV and oral cancers, recently reported these new findings at the American Academy for the Advancement of Science meeting.
This change in etiology, which has accelerated its influence over the last two decades as tobacco use in the U.S. simultaneously was declining, has also changed the demographics of who is getting the disease. It is no longer the domain of those over 50 who have smoked a decade or more of their lives. The fastest growing segment of the oral cancer population, are people in the 25-50 age range, who are never smokers, and that group predominantly comes to the disease from HPV16. Their oral cancers occur in locations anatomically unique, mostly localized to the posterior of the mouth; in the oropharynx, tonsils, and at the base of the tongue. This viral etiology makes identifying the “high risk” individual much more difficult.
Tobacco use in any form by itself continues to be an important risk factor for the disease. However, in the developed world, oral cancers are becoming more common because of persistent HPV16 viral infections. Evidence indicates that the virus can be sexually transmitted between partners, and accounts for the increase in young victims of oral cancer who do not fall into the historic, tobacco risk factor group. Additional risk factors include high alcohol consumption, the use of conventional smokeless (chewing/spit) tobacco, as well as prolonged exposure to the sun (for lip cancers).