Core Tip.
Recently, Oscar-winning actor Michael Douglas broke the news in an interview with the British newspaper The Guardian: “The reason I have cancer is because of the HPV virus caused by oral sex.” This “confession” quickly became explosive news in the entertainment industry. The divorced ex-wife of more than 10 years, Diane Della Duque, came forward first to claim that she did not have HPV infection, making Douglas’ current wife, the “goddess” of the Internet, Catherine Zeta-Jones, “lying shot”!
Many netizens were shocked by the incident and doubted whether oral sex and HPV were really so terrible, so they also consulted with experts online or at hospitals. In order to let people understand and prevent, doctors from Beijing Ditan Hospital have checked a lot of relevant literature and combined with clinical practice to make a sorting out of throat cancer, oral sex and HPV.
The more oral sex partners you have, the higher the chance of throat cancer
Douglas developed stage 4 throat cancer in 2010. Recently, he claimed that he contracted HPV and was infected with the virus because he had oral sex several times in the past.
HPV, also known as human papillomavirus, is a virus that easily infects the skin and mucous membranes. More than 100 serotypes have been identified, with about 35 types infecting the genital tract and about 20 types associated with tumors. HPV is a virus that can be transmitted through sexual intercourse. Studies suggest that squamous cell carcinoma of the head and neck may be caused by infection with sexually transmitted viruses such as HPV. Studies have confirmed that 70% of newly identified oral cancer patients are infected with HPV, surpassing tobacco as the leading cancer-causing factor.
Numerous epidemiological surveys have found that the main risk factors for laryngeal cancer are long-term smoking, alcohol consumption and air pollution, precancerous lesions, radiation, and exposure to occupation-related carcinogens. in 1982, Syrjanen
KJ first proposed that HPV infection was associated with laryngeal cancer. This is because the mucosal epithelium of the larynx is also a susceptible site for HPV, and high-risk HPV types, especially HPV16, are closely associated with the development of laryngeal cancer. In 2007, a study published in the New England Journal of Medicine found that the more oral sex partners one has, the greater the chance of developing throat cancer.
It should be noted that whether HPV infection can independently cause throat cancer, how exactly HPV interacts with other risk factors (smoking, alcohol, etc.), the clinical significance of HPV for throat cancer and its prevention and treatment, its impact on the prognosis of throat cancer patients, and its role in the recurrence of throat cancer after treatment are not well understood and need to be further studied. Regardless of future findings, Douglas’ story reminds us that oral sex is not safe and can lead to cancer!
Oral sex can transmit all STDs
Oral sex can also transmit gonorrhea, chlamydia, syphilis, HIV, and almost all other STDs. Oral-vaginal, oral-penile, and oral-anal are all at risk of transmitting these diseases. STD pathogens can be crossed between the oral, urethral, vaginal, and anal “four ports”. Regardless of the mode of sexual activity, any infection with pathogenic pathogens or disruption of the local micro-ecological balance may lead to the corresponding disease.
Domestic studies have shown that oral sexually transmitted diseases caused by oral sex include oral herpes, oral syphilis, oral condyloma acuminata, gonorrheal stomatitis, oral chlamydia, oral venereal lymphogranuloma, etc. A study in Yunnan showed that oral diseases related to common sexually transmitted diseases, warts accounted for 50%, gonorrheal stomatitis accounted for 35%, oral syphilis accounted for 7%, AIDS accounted for 8%.
A male student at a college in Anhui, China, had oral sex with four same-sex men a total of 10-11 times during the 14-month period before he was found to be HIV-positive on a physical examination, never using a condom. The male student denied any other form of homosexual and heterosexual sex and denied access to drugs and blood transfusions. This suggests that he contracted HIV from having oral sex 10-11 times. a case of HIV infection from oral sex was also found at Beijing Ditan Hospital, although in that case both parties, one had a hard chancre (vulvar ulcer) of syphilis and the other had an oral ulcer.
The probability of HPV transmission through kissing and daily contact is small, and the vast majority of oral HPV infections can also be traced to the act of oral sex. One reason young people are generally more enthusiastic about oral sex is that they don’t have to worry about conception. Unfortunately, most people are less aware of the link between oral sex and STDs and mistakenly believe that the act is safe. 2011 CDC survey showed that 90 percent of adults, as well as 27 percent of 15-year-old boys and 23 percent of 15-year-old girls, had experienced oral sex. A U.S. study also noted that the overall rate of oral HPV infection was 6.9 percent, with 10.1 percent for men and 3.6 percent for women. The reason for the difference is unknown, but it is speculated that it is likely related to the act of oral sex, which is more prevalent among gay men in particular. The study also showed that oral HPV infection was highest in people in their 60s at 11.4%, while the highest cervical HPV infection rate was in women aged 20-25. The more oral sex partners one has, the greater the chance of HPV infection, up to 20 percent for those with more than 20 sexual partners, compared to less than 1 percent for those who reported being virgins and 4 percent for those who had sex but had never had oral sex. In 2001, 26 cases of oral warts were reported in China. 13 cases were found in the tongue ligament, 5 in the palate, 2 in the gingiva, 2 in the inner part of the lower lip, 2 in the edge of the tongue, 1 in the pendulous, and 1 in the vocal cord.
What conditions are prone to HPV infection
HPV infection is one of the most common sexually transmitted infections, and both carriers and patients of HPV are the main sources of infection. HPV is highly infectious and is most often transmitted by direct or indirect sexual contact, and it can be transmitted to others before warts are produced or without obvious symptoms. In addition, close contact, skin abrasions, birth through the mother’s HPV-infected birth canal, self-inoculation (transmission to other parts of the body through scratching) and contaminant transmission are also relatively common indirect transmission routes.
The prevalence of HPV infection depends mainly on the age and sexual habits of the population. Domestic and international studies have found that HPV infection rates are highest among sexually active young women, with a peak age of 18-28 years, and decline significantly with age. Risk factors that predispose to HPV infection are.
(1) Having multiple sexual partners;
(2) Excessive sexual activity;
(3) Early initiation of sexual activity (before age 16);
(4) Unprotected sexual contact;
(5) Other sexually transmitted diseases in themselves or their partners;
(6) Low immune function due to tumor, autoimmune system disease, organ transplant, AIDS or other reasons.
Seven types of cancers are associated with HPV infection
Cervical cancer: Studies have reported that 5.5% of existing cancers worldwide are directly or indirectly related to HPV, the most common of which is cervical cancer. Cervical cancer has the second highest incidence rate among female malignancies, and about 20,000 women die from cervical cancer each year in China. Cervical cancer is by far one of the most reliable malignancies known to be viral in origin. There are many causes of cervical cancer, such as too many sexual partners or too much sex, too many pregnancies, too many births, smoking, and frequent use of oral contraceptives. Current research confirms that HPV plays an extremely important role in the occurrence and development of cervical cancer. HPV infection is necessary for the development of cervical cancer, especially high-risk HPV infection has a clear relationship with the development of cervical cancer. Studies in the last decade have shown that HPV is the main causative agent of cervical cancer and pre-cancerous lesions, and HPV can be detected in almost all cervical cancer tissues, especially persistent high-risk HPV infection is the main cause of cervical cancer (note that the meaning of this statement cannot be interpreted the other way around to mean that 99.7% of high-risk HPV infections will develop into cervical cancer).
Oropharyngeal cancer: A large number of domestic and foreign studies have confirmed that HPV infection is related to the development of squamous cell carcinoma of the head and neck. Studies have found that 50% to 90% of squamous cell carcinomas of the oropharynx, tongue and tonsils are associated with HPV infection, and the relationship between oropharyngeal cancer and HPV infection is even stronger, and there is more and more “evidence-based medical evidence”. Oral squamous cell carcinoma occurs easily in the oral mucosa and has a high degree of malignancy. In addition to risk factors such as smoking and alcohol consumption, the occurrence of oral tumors is related to HPV infection, especially the relationship between high-risk HPV and oral squamous cell carcinoma, and the effect of HPV on oral cancer even exceeds that of smoking.
Skin cancer: skin cancer can be divided into two categories: melanoma and non-melanoma, and the most common ones are malignant melanoma, squamous cell carcinoma and basal cell carcinoma. HPV usually infects the skin from childhood, and the skin of normal children and adults can be infected with different types of HPV. 80% of adult skin has been infected with HPV. Numerous studies have shown that skin malignancies may be associated with HPV infection, and the rate of HPV infection varies among different types of skin cancers. High-risk HPV infection is predominant among skin cancer patients. In non-melanoma associated with renal transplant recipients on long-term immunosuppression, the rate of HPV infection is 20-fold higher than that of normal subjects. In addition, data suggest that epithelial tumors such as Bowen’s disease and Pazzer disease of the skin are also associated with such viral infections.
Bronchopulmonary cancer: HPV associated with bronchopulmonary cancer includes both tumorigenic and non-tumorigenic HPV, but non-tumorigenic types are uncommon.
Esophageal cancer: Syrjanen
KJ et al. first suggested that high-risk HPV infection might be a risk factor for esophageal squamous cell carcinoma in 1982. Many scholars have subsequently studied the relationship between HPV and esophageal cancer, but the conclusions are not entirely consistent. The prevalence of HPV infection in esophageal cancer varies from 0% to 100% in different regions, and even the prevalence of HPV infection in the same regions is very inconsistent. However, in general, there are significant differences in HPV infection rates between regions with high and low prevalence of esophageal cancer.
Anal-anal canal cancer: A growing body of data suggests that malignancies in the anal-anal canal region are also strongly associated with HPV, especially high-risk HPV, which is more prevalent in the homosexual population. This is more common in the gay population, where warts in the anal canal area are common. When examining and treating them, it is important not to forget to rule out the possibility of high-risk HPV infection and early cancer.
Breast cancer: High-risk HPV-DNA can be detected in certain breast tumors, and a study in the British Journal of Cancer reported that high-risk HPV was present in 39% of ductal carcinomas in situ and 21% of invasive ductal carcinomas. The report suggests that HPV may play a pathogenic role in some breast cancers. Vaccination with HPV to prevent cervical cancer may prevent some types of breast cancer.
Overall, high-risk HPV16 infection is a risk factor for the development of cancers of the perineum, vagina, penis, anus, oral cavity, and oropharynx, and has been associated with laryngeal cancer. High-risk HPV type l8 is also associated with most of the above cancers. Low-risk HPV6 and HPV11 are not associated with cervical cancer, but are associated with laryngeal cancer, and are also associated with perineal, penile and anal tumors. Some HPVs are associated with squamous cell carcinoma of the skin. It is speculated that HPV may also be associated with malignant tumors of the lung, esophagus, rectum, colon, breast, ovary, prostate, bladder, nose and sinuses, and squamous cell carcinoma of the conjunctiva of the eye.
What other diseases HPV can cause
In fact, in addition to malignant tumors such as laryngeal and cervical cancers and oral cancer, HPV can also cause a number of other benign lesions (benign lesions are for malignant tumors, not that benign lesions are not serious).
A growing number of studies have shown that among HPV-associated diseases, different diseases can be caused by one type of HPV or multiple types of HPV, and conversely the same type of HPV can cause different diseases. The most common types of benign lesions caused by HPV are on the skin and anus, genital area, and most of them are caused by low-risk HPV viruses.
1, condyloma acuminata: in all HPV type, there are more than 40 kinds of can infect people anus, genital mucosa, often cause condyloma acuminata and other genitourinary tract diseases, the most common type is HPV6, 11, 40, 42, 43, 44 type. The most common types are HPV6, HPV11, 40, 42, 43 and 44. HPV6 and HPV11 are the most important HPV types, which are absolutely dominant in all countries in the world.
2, recurrent respiratory papillomatosis: Recurrent respiratory papillomatosis is a viral origin disease, usually caused by HPV6 and HPV11, often accompanied by exophytic airway damage. Although morphologically benign, the disease has potentially malignant consequences because of airway involvement and risk of malignancy.
3, common warts, flat warts, filiform warts, perineural warts, plantar warts, etc.
The above common benign proliferative skin diseases are also associated with some HPV subtypes.
Treatment and prevention of HPV-related diseases
There are many treatment methods for HPV and related diseases, including physical therapy, chemotherapy, biological therapy, surgery and Chinese medicine. However, so far, no single method is the best, and a good balance between comprehensive and individualized treatment needs to be found in clinical practice. There are many drugs and methods used in clinical practice to treat HPV infection in the genital tract, but there are difficulties in clearing HPV and related lesions with single treatment methods, and combined treatment may yield desirable results. Treatment of patients with condyloma acuminatum and other HPV infection-related diseases is individualized and based on the patient’s disease status. The use of appropriate treatment is the key to rapid and complete cure of HPV infection-related diseases.
There are three types of HPV vaccines. The first is a preventive vaccine, to be administered to young women before they become infected with HPV, and is not effective for women who are already infected with HPV or have existing cervical precancerous lesions and cervical cancer; the second is a therapeutic vaccine, to treat patients who are already infected with HPV or have existing cervical lesions; and the third is a vaccine that can be used for both prevention and treatment. Currently, preventive vaccines are available.
The most important target groups for the prophylactic HPV vaccine are school-age children and adolescents, and the most ideal period for vaccination is before first sexual intercourse and before HPV exposure. Since 30% of cervical cancers are not caused by HPV 16/18, but by other HPV high-risk subtypes. Routine cervical cancer screening should still be continued for women who have received the HPV vaccine. In the United States, the vaccine is not recommended for women older than 26 years of age. It is undesirable to be overly confident that vaccination will protect against HPV infection or cervical cancer and therefore instead engage in higher-risk sexual activity and neglect regular screenings. The duration of protection from any one vaccine is limited, and the HPV vaccine does not protect against all types of HPV subtypes of infection. There is currently no HPV vaccine available in mainland China.