I have HPV!?
Spouses Don't Face Infection Risk from HPV-Positive Throat Cancer Partners, Study Finds
Partners of patients with HPV-positive oropharyngeal cancer — a type of head and neck cancer — don't have an increased risk for oral HPV infections, according to new research.
By Jessica Firger
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MONDAY, June 3, 2013 —Spouses of patients with HPV-positive oropharyngeal cancer are not at an increased risk for developing an HPV oral infection and therefore, statistically, aren't more likely to develop HPV-positive throat cancer. The news from a new study may help to ease the anxieties of HPV-positive head and neck cancer patients, some of whom fear transmitting HPV to a partner through intimate activities.
The finding of the Human Oral Papillomavirus Transmission in Partners over Time study (HOTSPOT) were presented Saturday at the American Society of Clinical Oncology's annual conference. Gypsyamber D'Souza, PhD, an associate professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, began her pilot study several years ago in response to the clinical experience of many oropharyngeal cancer patients.
"They had a lot of questions and concerns about HPV transmission," said Dr. D'Souza. "There were divorces and changes in sexual behavior that patients were concerned about."
For the study, D'Souza and her fellow researchers recruited 147 patients with HPV-positive oropharyngeal cancer, along with 83 of their spouses and partners. The majority of patients enrolled in the study were men, while the majority of the spouses were women. The median age for study subjects was 56.
Five percent of the female partners were found to be HPV positive — about the same as would be expected in the general population.
D'Souza's findings are good news to many patients, but she emphasized the need to do a better job educating patients — and the public — on the actual cancer risk posed by HPV. "HPV-associated head and neck cancer is often very stigmatized and there are misconceptions about how HPV is transmitted," said D'Souza. "Some patients had concerns if this indicates infidelity or high risk partners. Instead we see with the infection that it only takes one partner and that it’s just bad luck if you're not able clear it."
The human papillomavirus is the most common sexually transmitted infection in the United States. According to the Centers for Disease Control, approximately 79 million Americans currently have an HPV infection, though around 90 percent of those infected with the virus don't have any symptoms or develop cancer. The virus is the leading cause of cervical cancer, but in recent decades, the rates of HPV-related head and neck cancer have risen dramatically, especially among white men. The reasons for the increase among white men are unknown, but one possibility is that increasing rates of oral sex have contributed.
Erich Sturgis, a professor in the department of head and neck surgery and the department of epidemiology at MD Anderson Cancer Center, said men may be at higher risk for contracting an oral HPV infection because a woman carries higher levels of HPV once she's infected. "There’s data out there that if you measure the viral load in cervix samples versus penile samples, there's a much higher viral load in the cervix," he said — adding that might mean oral sex is riskier for men.
Sturgis said he wasn't surprised by the study's findings. "It’s basically how we’ve been counseling patients and their spouse for years." He added that some head and neck cancer patients don't know how long ago they may have contracted HPV or even how it may have happened. By the time patient develops cancer, the HPV is unlikely to be communicable, Sturgis explained, which means a partner's risk for an oral HPV infection is low.
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