February 20th, 2011
02:04 PM ET

Yes, oral sex is sex, and it can boost cancer risk

Here's a crucial message for teens: Oral sex carries many of the same risks as vaginal sex, including human papilloma virus, or HPV. And HPV may now be overtaking tobacco as the leading cause of oral cancers in America in people under age 50.

"Adolescents don’t think oral sex is something to worry about," said Bonnie Halpern-Felsher professor of pediatrics at the University of California, San Francisco. "They view it as a way to have intimacy without having 'sex.'"

Halpern-Felsher and other researchers presented the latest information about the risks of contracting an HPV infection Sunday at the American Association for the Advancement of Science annual meeting.

The latest data suggest that 64% of oropharynx cancers - growing in the middle part of the throat - in the United States are caused by HPV, which is more than tobacco causes, said Maura Gillison of Ohio State University. And as the number of partners on whom you have performed oral sex goes up, the risk of oropharnyx cancer goes up.

About 37,000 people per year receive a diagnosis of  oral cancer, according to the Oral Cancer Foundation.

Just about everyone has had at least one of the 130 strains of HPV. The vaccines currently available, Gardasil and Cervarix, only protect against a few of them. But not all of the strains are cancer-causing. Certain types cause warts on the hands and feet that are benign.

About 5% of cancers worldwide are caused by HPV, and some turn up in some surprising places. A University of Washington study found that some men carry HPV 26 under their fingernails, which can lead to a form of cancer called digital squamous cell carcinoma. Proper hand-washing can help prevent this from happening, said Dr. Diane Harper, leading HPV researcher at the University of Missouri in Kansas City.

But this isn't nearly as common as HPV causing cancer in other areas of the body, such as the oral cavity and the cervix.

In the countries that have cervical cancer screening, the prevalence of cervical cancer is five times lower than in other countries, indicating that the testing is effective, Harper said.

Why HPV causes cancer in some people and not others is still mysterious. Studies of the cervix have found that 70% of infections resolve by themselves within one year, and 90% within two years. It's that remaining 10% that actually turn into more serious infections, and 5% lead to treatable precancerous lesions, Harper said.

Two well-established mechanisms of prevention in terms of sexually transmitted HPV are condom usage and circumcision, although neither completely eliminates the risk, Harper said.

A large ongoing study called HITCH is examining questions of HPV transmission and infection in greater detail. So far, it's found that couples can "ping-pong" HPV back and forth to each other, which is one reason  that the virus may take so long to clear naturally.

As for getting HPV from kissing, that's not clear, and there isn't enough data to say anything about it yet, Harper said.

It's very hard to get teens to listen to abstinence messages about oral sex, or to get them to use any kind of barrier method for these behaviors, Halpern-Felsher said. And since any risk factor under 50% sounds low to a very young person, throwing these precise statistics at them most likely won't make a difference.

But parents should have honest conversations with their teenagers about oral sex, Halpern-Felsher said. Tell them that the consequences of HPV may not happen right away, and while the risks may not be huge, they are significant. Potential long-term outcomes of cancer are quite concerning.

soundoff (356 Responses)
  1. james

    quick call cathy and tell her 1995 called and it wants it's joke back.

    February 20, 2011 at 14:42 | Report abuse |
    • Corey

      Haha Epic Win!

      February 20, 2011 at 15:12 | Report abuse |
  2. SOCAL frank

    I didn't want to live that long anyhow.

    February 20, 2011 at 14:43 | Report abuse |
  3. D. Handy

    What a load!

    February 20, 2011 at 14:44 | Report abuse |
  4. Will

    Seriously? The amount of alarmism in this country has officially gotten out of hand.

    February 20, 2011 at 14:44 | Report abuse |
    • bobby

      Yeah, but alot of teens don't know this info.

      February 20, 2011 at 15:12 | Report abuse |
    • Ben There

      @Bobby: You've obviously no experience with teens if you think they'll actually pay attention to sound advice.

      February 20, 2011 at 15:24 | Report abuse |
    • Steve P

      Alarmism? Interesting comment...could you elaborate?

      February 20, 2011 at 15:48 | Report abuse |
    • BimBum

      If only we could make life perfect, huh?

      February 20, 2011 at 15:59 | Report abuse |
    • Wzrd1

      Alarmism is bad, huh? Cancer is good?
      And idiocy must be great, huh?
      The article explains how a virus that causes cancer is transmitted. You call that alarmism?!
      Heaven forbid ANYONE EVER tell someone that something causes disease, that is alarmism!

      February 20, 2011 at 16:05 | Report abuse |
    • DBnNH

      @ Ben There
      Yes, unfortunately, teens are smarter than us . . . until they grow up and have kids of their own. . . !

      February 20, 2011 at 16:16 | Report abuse |
    • Patricia

      downplay much?

      February 20, 2011 at 17:12 | Report abuse |
  5. Alan

    The Joker said it best... If you gotta go... go with a smile!

    February 20, 2011 at 14:45 | Report abuse |
    • Bobby Cole

      Or in this case a mouthfull.

      February 20, 2011 at 15:35 | Report abuse |
  6. Brian C.

    I can't wait! Next it will be toilet paper causes rectal cancer!!!

    February 20, 2011 at 14:47 | Report abuse |
    • jamie


      February 20, 2011 at 15:14 | Report abuse |
    • ringo

      Well yes, if it's bleached paper, since chlorine bleach causes dioxin formation.

      Alternatively, if you use recycled paper, it could contain pulp from heat-activated paper like cash register receipts, which contain BPA.

      Just don't poop.

      February 20, 2011 at 15:16 | Report abuse |
    • Sherlock

      Now we know why so many people are full of...

      February 20, 2011 at 15:24 | Report abuse |
    • Steve P

      No, but HPV will be linked there as well...anywhere there is squamous epithelium coming in contact with HPV, there is the chance of malignant transformation. The laryngeal cancer is no surprise at all. In fact, HPV induced laryngeal papillomatosis can actually migrate to the lungs and lead to a cystic process that can transform to squamous cell carcinoma. It's a bad player. It's not alarmism. It's not "just another thing". It's a very real risk factor for a very unpleasant head and neck cancer that is mostly preventable, as is cervical cancer. Will it impact behaviors? Not likely, but it might (appropriately) lead to a greater awareness and increase in vaccination rates (hopefully).

      February 20, 2011 at 15:52 | Report abuse |
    • BimBum

      Scare Tactics, Fear and Guilt
      have been mankind's oldest psychological People Control mechanisms
      -just ask the religions.

      Now: does this newly-scary stuff apply
      to us carpet munchers,too? or just to Monica Lewinsky et al.?
      I always thought Oral was a reciprocal 50/50 arrangement (or should be..)

      February 20, 2011 at 16:03 | Report abuse |
    • Wzrd1

      Bimbum, there was no discussion in the article about morality of practices, only the mention of something people call "safe" DOES transmit an STD. How HORRIBLE of them!
      We might offend the morons.

      February 20, 2011 at 16:07 | Report abuse |
    • Steve P

      Scare tactics...good stuff. I could see how someone not really having a great understanding of oncology and virology might find science to be "scary". Thing is, though, it's only a true scare "tactic" if it is exaggerated or fabricated to produce a given effect. The problem with that is that HSV is, without question, an instigator of squamous cell cancer in a very clear and easily understandable mechanism. Not a scare tactic to those with any kind of understanding. Come on, folks, don't comment on stuff you don't understand.

      February 20, 2011 at 16:35 | Report abuse |
    • Tom McCormick

      Oh my God, toilet paper too. I guess I'll be out of harm's way for the oral worries. Because I'm going to stink. 🙂

      February 20, 2011 at 19:16 | Report abuse |
    • Suffering

      As far as I know, toilet paper doesn't cause rectal cancer; however, some strains of HPV cause genital warts, which, if in the right area, will cause rectal cancer....personal experience unfortunately.

      February 20, 2011 at 19:58 | Report abuse |
  7. SueEllen

    I'll take my chances. :p~~~~~~~~

    February 20, 2011 at 14:48 | Report abuse |
    • BirrCrinton

      "I do not avoid women, Mandrake. But I do deny them my essence." - Gen. Jack T. Ripper to Group Capt. Lionel Mandrake in Dr. Strangelove

      February 20, 2011 at 15:28 | Report abuse |
    • Rex O Slate

      But DO avoid the fluoride!!!!!! It is a trap!!!!!

      February 20, 2011 at 17:05 | Report abuse |
    • lucky louie

      Thank you, thank you, SueEllen. We need more courageous women like you.

      February 20, 2011 at 17:15 | Report abuse |
  8. Rob

    Can someone bury this story? I have a date next weekend....

    February 20, 2011 at 14:49 | Report abuse |
  9. Just Say No to WASPs

    Just another way for the government and its scientists to try and take our fun away. You get cancer from eating frozen processed food, household cleaners, and sunlight; your going to die anyways, at least try to enjoy life.

    February 20, 2011 at 14:50 | Report abuse |
    • Dave

      That is to funny...but true at the same time

      February 20, 2011 at 14:51 | Report abuse |
    • lauren

      ohh sheeesh, i beleive that 'everything', meaning every or any given thing can cause cancer. i once heard the word 'disease' is derived from the words 'dis ease'. i also strongly believe that the hiv virus is present in something as simple as saliva, thus possibly cancer causing as well... 'time will tell...

      February 20, 2011 at 15:26 | Report abuse |
    • Wzrd1

      You are RIGHT! We should NOT try to avoid death! We should do everything we want to do and if it kills us, COOL!
      After all, protecting oneself is bad. Taking stupid risks is good! As long as we enjoy it!
      Take stupid risks! Die young! Get cancer and have your face and throat carved up, it's COOL!

      February 20, 2011 at 16:09 | Report abuse |
  10. gfgf

    who cares, its not like any of us are getting out of this alive

    February 20, 2011 at 14:50 | Report abuse |
    • yup

      well said

      February 20, 2011 at 15:22 | Report abuse |
    • abc


      February 20, 2011 at 15:26 | Report abuse |
    • Wzrd1

      Yeah, dying young isn't a big deal. Except, possibly to someone dying young from cancer.
      So, who cares? Die young, die old, it's all the same to morons.

      February 20, 2011 at 16:11 | Report abuse |
    • Optimist

      Life is a terminal disease with a terrilbe prognisis....

      February 20, 2011 at 18:06 | Report abuse |
    • Optimist

      * no editor.grrrrrrrr...prognosis

      February 20, 2011 at 18:08 | Report abuse |
  11. Laughable

    Didn't know bill was into the San Francisco teat.

    February 20, 2011 at 14:50 | Report abuse |
  12. new low

    So is this another version of "You'll go blind!"?

    February 20, 2011 at 14:50 | Report abuse |
    • Dave

      Maybe... Or else you'll grow hair on your hand

      February 20, 2011 at 15:00 | Report abuse |
    • Al

      Actually, it's more about "Don't go in blindly." But hey, who's listening?

      February 20, 2011 at 15:01 | Report abuse |
  13. harry palms


    February 20, 2011 at 14:52 | Report abuse |
  14. SF GoDown

    Im planning my funeral today, after I make my final few house visits.

    February 20, 2011 at 14:53 | Report abuse |
  15. Benjamin

    Purity and self-control are very underrated virtues in America.

    February 20, 2011 at 14:55 | Report abuse |
    • redd52

      agreed agreed agreed agreeeeed

      February 20, 2011 at 14:59 | Report abuse |
    • steven harnack

      But they are very popular with anal-retentives.

      February 20, 2011 at 15:08 | Report abuse |
    • Wzrd1

      Using protection is a virtue so underused in this country.

      February 20, 2011 at 16:12 | Report abuse |
  16. john

    oh well I guess I'm a dead man walking

    February 20, 2011 at 14:55 | Report abuse |
  17. Sol

    What if you have the HPV vaccine? This is a serious question. Also, I would really like to see who funded this study. Big Pharma has been pushing the HPV vaccine down everyones throat...talk about oral...

    February 20, 2011 at 14:57 | Report abuse |
    • TB1

      Yes the HPV vaccine covers the 4 strains of the virus most associated with HPV infections and cancer caused by HPV. As for the study I can't answer that but there are several medical pathology books that mention oral cancer and infection with HPV.

      February 20, 2011 at 15:14 | Report abuse |
    • Wzrd1

      HPV vaccine covers 4 out of 8 known strains of HPV. They're working on the rest still.
      There is also XMRV, which has no vaccine.
      Hence, the warning.

      February 20, 2011 at 16:14 | Report abuse |
    • thersa

      Should men get HPV vaccinations too, then?

      February 20, 2011 at 16:52 | Report abuse |
  18. SS


    February 20, 2011 at 15:00 | Report abuse |
  19. Bj

    so if you get throat cancer than you probably suck to much .........?

    February 20, 2011 at 15:04 | Report abuse |
    • Evan

      Bj wrote: "so if you get throat cancer than you probably suck to much .........?"

      Yea, that really sucks doesn't it?

      February 20, 2011 at 15:08 | Report abuse |
    • houseofpayne

      We all knew that smoking and chewing tobacco increased one's cancer risk in the mouth and throat, and they're telling us that oral action may be a factor as well?
      This reminds me of the joke that made its way soon after AIDS was discovered and researcers weren't sure of the cause, but had identified high risk groups: "I was just diagnosed with AIDS, and the hardest part about it was convincing my family that I'm Haitian".
      I can see it now: "I was just diagnosed with throat cancer, and the hardest part about it was convincing my family that I used tobacco"...

      February 20, 2011 at 18:04 | Report abuse |
    • Optimist

      (Old one...) Please, don't tell my family I work in the oilfield. They think I'm still a piano player in a wh0rehouse.

      February 20, 2011 at 18:11 | Report abuse |
  20. mdiver

    No more yodeling in the canyon.

    February 20, 2011 at 15:05 | Report abuse |
    • BirrCrinton

      Climb out of the stench trench!

      February 20, 2011 at 15:26 | Report abuse |
  21. ratm33

    What a bunch of crap. Keep sucking!!!!!!!!!!!!!!!!!!!!

    February 20, 2011 at 15:06 | Report abuse |
  22. James Beam

    Really? Apparently it doesn't matter what you're smoking these days.

    February 20, 2011 at 15:06 | Report abuse |
  23. Evan

    I doubt throat cancer is what Diana Ross had in mind when singing her famous lyrics "If there's a cure for this, I don't want it, don't want it..."

    February 20, 2011 at 15:07 | Report abuse |
  24. HA

    We shouldn't do anything anymore. Crawl into a hole. I'm selling my mountain bike because it can cause a scratch.

    February 20, 2011 at 15:08 | Report abuse |
  25. MXD

    I find this whole thing REALLY hard to swallow.

    February 20, 2011 at 15:09 | Report abuse |
  26. Ty

    Where can I sign up to be a part of this study?

    February 20, 2011 at 15:09 | Report abuse |
  27. paul c bryant

    wow! smh! jesus

    February 20, 2011 at 15:10 | Report abuse |
  28. Ralph

    So will those militant anti-smokers now turn militant anti-oral?

    Will the SF Supervisors make SF anti-oral like their trying to make the city anti-smoke?

    Ah the irony.

    February 20, 2011 at 15:12 | Report abuse |
    • Flora

      No, because you can't get second-hand HPV.

      February 20, 2011 at 15:58 | Report abuse |
  29. Richard B.

    It's something I love to do to the little lady I shall never quit eatting.

    February 20, 2011 at 15:12 | Report abuse |
    • Optimist


      February 20, 2011 at 18:13 | Report abuse |
  30. iPad

    Did you notice there are very few female commenters on this article. What's up with that?

    You girls busy with something else?

    February 20, 2011 at 15:13 | Report abuse |
  31. Larry

    I think this requires further study. I volunteer for further research.

    February 20, 2011 at 15:15 | Report abuse |
    • BirrCrinton


      February 20, 2011 at 15:25 | Report abuse |
  32. HIVMan

    Well darn, I got nothing to lose...

    February 20, 2011 at 15:16 | Report abuse |
  33. Jane

    Whew... that's a load out of my mouth

    February 20, 2011 at 15:17 | Report abuse |
  34. munkittrick

    You're doing it wrong.

    So much for having your head and getting it too.

    We all have to go some way...it might as well be fun.

    February 20, 2011 at 15:19 | Report abuse |
  35. Guest

    at least now when you are diagnosed with throat cancer you can say it was the chicks not the cigs.

    February 20, 2011 at 15:21 | Report abuse |
  36. ufb

    Noooooo again.... Another person who thinks they can avoid STD's by "being picky!" STD's are equal opportunity afflictions. Beautiful, smart seemingly abstemious people are just as likely to have one as are dumb, ugly or apparently promiscuous people.

    February 20, 2011 at 15:22 | Report abuse |
  37. BirrCrinton

    A nice cigar works much better!

    (A woman's just a woman, but a good cigar is a SMOKE!)

    February 20, 2011 at 15:24 | Report abuse |
  38. Rick

    Teens need to stop sleeping with older people. Sure he's 35 and worldly, but he's full of worldly disease and frankly he looks terrible naked.

    Stick to your own age.

    February 20, 2011 at 15:24 | Report abuse |
    • DS

      uhh... how old are you that you think this type of thing is common? Old people thinking young people are doing "WIIIILLLD AND CRAAAZY THINGS!" all the time just widens the mental generation gap, which causes all sorts of problems for everyone.

      February 20, 2011 at 18:40 | Report abuse |
  39. OTTO

    This story blows...

    February 20, 2011 at 15:24 | Report abuse |
  40. Farhan

    This is why the standard of care should be to immunize adolescent boys as well as adolescent girls with the HPV vaccine. This is long overdue.

    February 20, 2011 at 15:25 | Report abuse |
    • Julia

      It has already been approved for boys and men up to age 26.

      February 20, 2011 at 18:07 | Report abuse |
  41. ronald mcdonald

    This is tough to swallow...

    February 20, 2011 at 15:26 | Report abuse |
  42. Christian Szell

    Well that sure puts a damper on things, doesn't it?

    February 20, 2011 at 15:27 | Report abuse |
  43. yup

    I'm convinced these doctors just pick things everyone does and say that is the "root cause." Some people get cancer. Some people don't.

    One of my neighbors liked to 94 and she chain smoked Camel non filter cigarettes all day long.

    A guy I worked with was 24 when he got lung cancer and never smoked anything his entire life.

    Like someone said earlier, nobody gets out alive, its a matter of when and how not if you are going to die.

    February 20, 2011 at 15:27 | Report abuse |
  44. GenDoc

    This is why everyone should just get the HPV vaccine; even men.

    February 20, 2011 at 15:29 | Report abuse |
    • Yougotwhatyouwanted

      Yup and that is exactly what the manufacture res want you to do. I would not be one bit surprised to see they sponsored this study. I'll wait to see these results duplicated.

      February 20, 2011 at 16:09 | Report abuse |
    • Doc

      The HPV vaccine is not proven. Like this article, more propaganda for the insurance companies to sell their crap. The number of partners is much more of concern than this half-baked vaccine.

      February 20, 2011 at 18:33 | Report abuse |
    • Mark

      Sure, I'll take cancer before I get a vaccine. I'm sure glad our grandparents and parents were not as stupid when Polio and small pox vaccine came around. Ever wonder why we never see cases of those diseases. Oh that's right, the vaccine stopped the spread of the disease. Damn vaccines.

      February 20, 2011 at 18:58 | Report abuse |
  45. Michael

    Make sure your partner washes their genitals good before blowing into the mic.

    February 20, 2011 at 15:29 | Report abuse |
  46. BirrCrinton

    "Women sense my power and they seek the life essence. I do not avoid women, Mandrake. But I do deny them my essence." - Gen. Jack T. Ripper to Group Capt. Lionel Mandrake in Dr. Strangelove

    February 20, 2011 at 15:31 | Report abuse |
    • brandi

      u confusse me sir i am only 14 an my parents made me read this this whole thing is kinda stupid it made to scare me

      February 20, 2011 at 17:54 | Report abuse |
  47. Fricsaid

    Try all you want, my GF is not going to be hearing about this. No one. I repeat, no one is going to take this away from me.

    February 20, 2011 at 15:32 | Report abuse |
  48. T3chsupport

    I will die how I lived!

    February 20, 2011 at 15:32 | Report abuse |
    • hummer

      ...on your knees?

      February 20, 2011 at 18:57 | Report abuse |
  49. oncology rn

    Laugh all you want and be cynical now because you won't be laughing when you have to go through radiation to the head/neck because of risky behaviors that lead to your diagnosis of oral cancer down the road. You won't be able to swallow your own spit, your mouth and throat will look like raw hamburger, you will have a feeding tube, you will think you are dying-and you just might.

    February 20, 2011 at 15:32 | Report abuse |
    • BirrCrinton

      And you will live to be a 90-year old virginal nun, right?

      February 20, 2011 at 15:36 | Report abuse |
    • Yougotwhatyouwanted

      How much research have you done RN? I'm betting none. This is one study and until we see the actual data complete with methodology and it's results are duplicated. It means almost nothing, so stop trying to scare people with doomsday cancer scenarios. CNN is notorious for posting unsubstantiated studies and drawing ridiculous conclusions to increase web hits.

      February 20, 2011 at 16:07 | Report abuse |
    • Patricia

      what do you mean, what studies has he or she done? The facts are irrefutabal. Just as we don not need to do any more research on the affects of cigarettes because it is common knowledge – just as we know that HPV is cancer-causing.

      February 20, 2011 at 17:29 | Report abuse |
    • TB1

      If you want facts go search "HPV and Oral cancer" on pubmed and read the studies there. To sum up: alcohol, tobacco and hpv can all cause cancer.

      February 20, 2011 at 18:01 | Report abuse |
    • ufb

      Yes, and all the symptoms you describe are the side effects of the radiation. Yes, untreated, an oral cancer will ultimately take you there, but what you describe are the symptoms of crude, gruesome treatments for cancer. Medicine needs to do better in that regard, the treatments are still barbaric!

      February 20, 2011 at 18:31 | Report abuse |
  50. Bobby Cole

    I better block CNN on my wife's PC before she reads this.........

    February 20, 2011 at 15:33 | Report abuse |
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About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.