sex health

Oral Sex Is Killing You

Growing up, I thought oral sex just meant the possibility of mouth and neck strain, given the positions (and the duration of said positions) this type of sexual activity requires. But it turns getting on your knees, or laying beside your partner, or squatting over your trick could also kill you. Scientists have spotted a link between the rise in oral sex among young people and a spike in head and neck cancers, triggered, researchers presume, by the increased transfer of HPV, that nasty little STD that we already know can lead to cervical and anal cancer.

According to Dr. William Lydiatt, professor and chief of head and neck surgical oncology at the University of Nebraska Medical Center in Omaha, the overall incidence of head and neck cancers is going down, largely because fewer people are smoking (tobacco and drinking are the major traditional risk factors). But the incidence of cancers of the tonsil and base of the tongue have been going up over the past decades, he said. And those are the ones that are more likely to test positive for HPV.

“It’s gotten to the point now where 60 to 70 percent of all tonsil cancers in the U.S. are HPV-related,” Lydiatt said.

Although the link between HPV and these types of cancers is indisputable, the association with oral sex is strong but a little more speculative, experts say. A 2007 study in the New England Journal of Medicine found that younger people with head and neck cancers who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in their lifetime. In the study, having six or more oral sex partners over a lifetime was associated with a 3.4 times higher risk for oropharyngeal cancer – cancers of the base of the tongue, back of the throat or tonsils. Having 26 or more vaginal-sex partners tripled the risk.

And the association increased as the number of partners – in either category – increased. The researchers also reported that cancers of the tonsil and base of the tongue have been increasing every year since 1973, and wrote that “widespread oral sex practices among adolescents may be a contributing factor in this increase.” The researchers concluded that in their study, oral sex was “strongly associated” with oropharyngeal cancer, but noted that they could not “rule out transmission through direct mouth-to-mouth contact” such as French kissing.

Which means what exactly? That we either cut down on the oral sex, and even the french kissing, or risk developing HPV-related cancers? Ya know, I thought keeping myself clear of mono in college was an accomplishment, but apparently I’ve got all sorts of new fun things to worry about now.

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  • redball

    Got-dayum! I’ve always thought that the HPV vaccine should promoted as strongly for boys as it is for girls. Last I heard, it was mainly being framed by US medical professionals as a “young girls'” vaccine. No…No…No. Hell, conservative US parents had to be convinced, kicking and screaming, that their GIRLS even needed it in the first place.

    Hopefully that HPV vaccine policy has already changed or will soon change to include all boys and girls. Really sad.

  • Tomcat

    This isn’t new… and thus isn’t really news.

    The real news is in the fact that there is a vaccine well and truly available, but that in some countries, such as Australia, the government provides free HPV vaccine to young women only. But, although they acknowledge that the risk as as great or greater for men who have M2M sexual activity, they refuse to provide the vaccine to us. Due to the apparent limitation in supply (which may have now changed, but was the case for some time) we cannot access it even if we are willing to pay the hundreds of dollars for the unsubsidized vaccine, and majority of gay men are not even made aware of the issue because the multi-million dollar advertising campaign also only focused on women. This was also deliberately done to ensure supply to women, because if gay men found out the truth that we in fact need it more than those once-in-a-blue-moon goodtime gals, there would be a major backlash.

    The article as it stands is at least a year or two late, particularly as Queerty is one of the few places we apparently can go to be informed on issues in the GLBTI community.

    What you should be talking about is why the vaccine is still yet to be made appropriately available to the community, or why it’s somehow appropriate for health, research and government bodies to misdirect and conceal this risk to M2M active men instead of providing appropriate public health information.

    The double standard presented to the gay community in issues such as this, blood donation and AIDS research is nothing short of discriminatory, and frankly smarts of watered down pharmaceuticals and medications being sent off to 3rd world countries under the guise of international aid, or even borders on giving smallpox infested blankets (you know the reference I’m sure).

    While I have supported Queerty for years in concept, the semi-recent trend of lazy and outdated reporting is becoming institutionalized. You have a fantastic platform here to inform and interact with the international gay community, but I’m afraid it’s wasted on the current band of ‘journalists'(pretty much since the sites upgrade/new management). You may want to consider getting some more university educated writers to contribute instead of the 2-a-penny bloggers that are in vogue these days.

    And now for the indignant responses…

  • redball


    I think you hit on some really important points re: the necessity of HPV for GAY MEN (& young boys). VERY FISHY, this obfuscation of scientific data to the public. Why is the medical profession not addressing this head-on?

    My physician is gay and I’m going to ask him about this because, although I’m in my late 20s and I believe it’s not as effective this late in age, I’m interested in getting it.

  • JKB

    If this were true, I would have had head and neck cancer 20 times over.

  • Benjamin

    Strange to see this story adjacent to the one about the death of Charles Nolan, who died of head and neck cancer.

  • On The Road

    @JKB: The instances of these types of cancer in patients who have HPV is still very low (less than 1%). But in a large population sample even a cancer rate this low can cause thousands of deaths.

  • JT

    You’re WAY more likely to get HPV from anal or vaginal sex than you are from oral sex. I have gay male doctor friends who keep up on factual information on STDs and HIV and they have told me this.

    TomCat-I also agree with you that it is BS that the HPV vaccine Gardasil is marketed and available for women only and not for men at all.

  • IE

    @JKB: The virus doesn’t lead to the cancer for roughly 20 to 25 years. It isn’t an immediate thing, like catching a cold.

  • med student

    Here is the current information on, a centralized resource for clinicians (and secondarily, for patients) to be able to access the most factual and current information on diseases and treatments available. Basically, in 2009 the FDA approved the use of Gardisil in men, and the Advisory Committee on Immunization Practices recommended in 2010 to give the vaccine to men ages 9-26. Granted, the article takes a relatively moderate view on vaccination of men by acknowledging that it has its benefits and drawbacks, and it recommends first and foremost having a discussion about it in your specific case.

    The clinic at which I recently worked would recommend HPV for all the men (especially MSM) that came in, but when I went for my yearly checkup with my own GP and requested the vaccine, he was dumbfounded and really caught off guard. He said he’d have to do more reading and get back to me. So, as you can see, this is all relatively new information, and many physicians simply don’t know what the latest discussion is, but you can do your part by bringing up the issue and pushing for it if you feel strongly about it. Talk to your doctor!

    IMMUNIZATION OF MALES — Males can also acquire HPV-related disease including genital warts, and less commonly, penile and anal cancer, which is similar to cervical cancer in its close association with HPV infection [9].

    Interest in HPV vaccine efficacy and safety in boys and young men has not only included prevention of these diseases in males, but also possible decreased transmission of HPV infection to female sex partners. Studies with both GardasilTM (quadrivalent HPV vaccine) and CervarixTM (bivalent vaccine) show seroconversion rates that are noninferior to females (99 to 100 percent) with similar adverse event profiles [10,11]. The most common side effect was pain at the injection site. Although vaccine immunogenicity among males and females is comparable, there are no data on efficacy in the prevention of HPV-related disease in males other than genital warts. (See “Clinical trials of human papillomavirus vaccines”.)

    In 2009, the FDA approved the use of quadrivalent vaccine in males [12]. In 2010, the ACIP stated that “the quadrivalent vaccine may be given to males aged 9 through 26 years to reduce their likelihood of acquiring genital warts” [2,3].

    Opponents of HPV vaccination in males argue that [13]:
    -The burden of HPV-associated diseases such as anal, penile, and oropharyngeal cancers in men is much less than that of cervical cancer in women [14].
    -Public health initiatives should be focused on attaining high rates of immunization in young girls.
    -Most studies suggest that immunization of males, for the sole purpose of protecting females from infection, provides only a small incremental benefit and is not cost effective, especially if female programs obtain high rates of vaccine coverage [15]. On an individual basis, HPV vaccination of females is two- to fourfold more cost effective than vaccinating males [15]. However, when the HPV vaccination rate of females is low, both incremental benefit and cost-effectiveness of vaccinating males improves.

    Vaccine proponents of HPV immunization in males argue that:
    -Immunization rates in young girls have been generally low, particularly when immunizations are not mandatory [16].
    -HPV infection is common in men and is readily transmitted, influencing disease rates in both men and women [17,18].
    -Immunization of both sexes would induce “herd immunity” (eg, greater protection of the general public would decrease the risk of infection in those who do not get vaccinated).

    There is also a higher incidence of anal intraepithelial neoplasias, anal cancers and genital warts among MSM compared to heterosexual males [19]. Preliminary data suggest that the quadrivalent vaccine is immunogenic and safe in this population [20] and may be efficacious in preventing anal intraepithelial neoplasias in MSM.

  • redball

    @med student:

    Thank you, Doc! That is some really useful info

  • declanto

    @redball: Now we see what this site can and SHOULD be. Thanks for an informative and timely post!

  • Norma

    “Prevalence of oral HPV infection in the United States, 2009-2010” JAMA, Feb. 15, 2012, Vol 307, no. 7. pp. 693-703. Many public libraries have this publication, or can get it for you. There are 100 types of HPV; don’t count on a vaccine–doesn’t have a record (except in lab animals) for oral. Watch for neck masses, unexplained weight loss.

  • Anonimo

    I am no gay. Sorry. I am trying to change to be straight. Because gay is not good. It is bad and leads to unsuccessful situations. I tell you by experience. I do not want to experience God’s punishment anymore. God punishes me only because he loves me and he does not punish you. Because you do not deserve it. I deserve such punishment cause I am gay and should not be gay because I am not part of the gay societies. Cause that’s life. I am trying to change my views and become a holy man just like Jesus Christ used to be.

  • Anonimo

    I believe gay sex should be not permitted. It should be changed the law and be counted as felony and crime and put to jail. That’s all. I think United States should change the law and put all of the gays to jail for gay sex. I believe that gay sex must be punished to jail and be counted as a crime. I say because I have had bad experiences with the gay societies and I am gay and have been maltreated by them. I hope the White House pays attention to this who is an American Citizen who is pleading to set up laws here in U.S. I say these things to put liable punishments who are homosexuals and who practice such illicit sexual activities.

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