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Oral Cancer

Odds of Oral Cancer from HPV

06/21/2010

Question:

I am concerned about the possibility of developing oral cancer. I tested HPV positive 4 years ago (positive the first year, negative (I guess dormant) the second year and positive the following 2 years). I just got my first abnormal pap this month (ASCUS) and a colposcopy was performed determining low grade lesion -waiting for biopsy results. My gynecologist will not test to determine the exact strain(s) of HPV - so now I am worried and will never know if I have strain 16 or 18 that can cause oral cancer. What are the odds of having either of these strains and getting oral cancer? I have only had 3 partners and I am 40 years old. I’ve been with my husband for 9 years - he has had 6 partners. I know other sites that state increased partners increases your odds. I have never smoked and do not drink excessively (reducing other risks for oral cancer). Thanks for your time.

Answer:

I have discussed this with my gynecology-oncology colleagues. Most cervical HPV screenings look at a panel of several HPV types (9 different tumor associated strains), and as this does not currently affect our clinical decision-making.

Currently individual strains are typically not tested. For those oral (tonsil, tongue base regions) cancers that are associated with HPV, the large majority are due to HPV type 16.

Given the high frequency of HPV (various types) in the general population, and comparatively the low overall rate of oral cancer, it is thought that the rate of developing oral cancer due to having HPV infection is very low. (Some estimate that around 20% of the general population has HPV at any given time, and 70-80% risk of an individual having HPV over lifetime).

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Response by:

Amit  Agrawal, MD Amit Agrawal, MD
Associate Professor of Otolaryngology
College of Medicine
The Ohio State University