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Oral Sex and Oral Cancer

Beware headlines stating oral sex gives you cancer!

On Wednesday February 25, 2004, Reuters in London reported findings published in New Scientist Magazine stating a link between oral sex and oral tumors (cancers). The paranoid headline read "Oral Sex Shown to be linked to Mouth Cancer," and while the opening paragraph explained that the risk is small and more likely linked to smoking and drinking, the fire had been set and flames began to be fanned by media worldwide. Headlines began to run in newspapers, online news services and online journals, over eighty articles to date, titled "Oral Sex Mouth Cancer Link" and "Oral Sex Causes Mouth Cancer."

Responsible journalism rants and headline ethics questions aside, the headlines grossly oversimplified a health consideration and fed our culture of sexual fear, shame and repression. It was all too easy to skim the Reuters article, which left out pertinent details and stated:

"'Oral sex can lead to oral tumors,' New Scientist magazine said Wednesday, referring to the latest research... They found that patients with oral cancer containing a strain of the human papilloma virus (HPV) known as HPV16 were three times more likely to report having had oral sex than those without the virus strain. 'The researchers think both cunnilingus and fellatio can infect people's mouths,' the magazine added... 'This is a major study in terms of size,' he said. 'I think this will convince people.'"

What the quoted researcher was referring to was a link between HPV and oral cancer. But what message heard around the globe was that the sex act itself is the cause of cancer, much like the headline-fueled hysteria that still leads readers to believe that only gay anal sex leads to contracting HIV/AIDS.

HPV, short for human papilloma virus, is the virus associated with genital warts. What not many people know is that you can have HPV and never have a genital wart; in fact, most people who have HPV do not know they have it because it usually causes no symptoms. Approximately ten of the thirty identified strains of HPV can lead to the development of cervical cancer in women.

HPV is spread much like herpes, through skin-to-skin and mucous membrane contact when symptoms are apparent or simply "shedding." It is, and should be considered, highly contagious, and you are at much higher risk for contracting HPV through fellatio or cunnilingus than you are for HIV or hepatitis.

The symptoms of HPV can take several weeks or even months to appear, if they appear at all. They can be small, painless bumps or look like a collection of cauliflower-like constellations, appearing on the penis, scrotum, thighs, mouth, throat, anus, or vagina (vulva). There is no cure for HPV.

The Reuters article was the most widely read piece on the topic of oral sex and oral cancer. It didn't explain HPV or much else for that matter, and caused a wave of panic to sweep sexually themed message boards worldwide. What the Reuters article failed to explain was clarified in a Washington Post article, which was brief but stated the study's conclusion in regards to risk: "But the risk, say the researchers, is very small. Only about one in 10,000 people develop oral tumors each year, and most cases are probably caused by two other popular pursuits: smoking and drinking."

An article run by BBC News explained the study in detail, and shed more light on the links and risks between orally contracted HPV, smoking, and oral tumors. As it turns out, "Experts say heavy smoking or drinking causes most mouth cancers, but the HPV link could help explain why some young adults develop the rare disease. But they stressed people did not need to alter their behaviour."

The article continued to explain the study, its findings, and comments by researchers. "In the Johns Hopkins study, also published in the Journal of the National Cancer Institute, researchers compared 1,670 patients who had oral cancers to 1,732 healthy people from Europe, Canada, Australia, Cuba, and Sudan. They took tissue biopsies to see if the HPV virus was present. It was found in a small number of people with oral cancer." They also noted that fellatio and cunnilingus were equal transmission vehicles for HPV, stating, "The virus was equally likely to be present in men and women." In conclusion, "...Dr. Anne Szarewski of Cancer Research UK told BBC News Online people should not panic about the findings. 'It is important to add to our knowledge about cancer causes, but I wouldn't want to give the impression this is a major issue. Oral cancer is rare, and tobacco and alcohol are by far the biggest causes.'"

Risk is something that needs to be assed by the individual, and with knowledge about the dangers of lifestyle hazards, we can engage in responsible risk assessment. But meanwhile, not knowing the risks can be dangerous, even deadly, and a culture of shame and fear around oral sex can cause people to take risks that they are unaware of.

A lifetime of smoking and carrying HPV, unaware of the risk, is changing an acquaintance's life forever. His mother is losing her battle with oral cancer. "She started with cancer in her tonsils that is linked to -- you guessed it, HPV (her husband is HPV+) and smoking. Something about the combination makes it terribly magnified, according to her oncologist. Her cancer is now metastasized to her bones, which is one of the shittiest ways to die. All things being equal, I think the smoking was the major culprit, but giving bareback oral back in the day before anyone thought about it didn't help."

It pays to get tested for HPV, to know your partner and your risks, and to learn about using barriers for safer oral sex. Condoms for fellatio don’t taste great, but can act as an effective barrier against HPV. (Learn how to put one on with your mouth in Ultimate Guide to Fellatio.) Dental dams, thin squares of latex, work best for cunnilingus and analingus (rimming), and in a pinch you can use a cut-open condom or plastic wrap for these sexual activities. Gloves are recommended if you plan on getting your hands in the action, since HPV travels via skin contact, you run the risk of moving fluids from your hand to mouth, or hands to genitals if you touch yourself later without washing your hands thoroughly. Read more about safer oral sex in Hot Head: Safer Oral Sex for Guys and Gals.

But just as it pays to know your risks and use safer-sex barriers, it might pay just as well to similarly effective barriers when reading the news.