Head and neck cancers like oral cavity cancer, oropharyngeal tumours and laryngeal malignancies are some of the most common cancers affecting the Indian population. The main causative risk factors for these cancers are tobacco, smoking and alcohol. But Nowadays we are getting many patients who have not taken such substances in their life. Human papillomavirus (HPV) infection mainly HPV 16 has been present in the majority of such cases, said Dr Prateek Varshney- Director & Unit Head – Surgical Oncology, Fortis Hospital Shalimar Bagh.
Dr Prateek Varshney said, research has shown that some sexual practices, mainly Oral sex and an increased number of sexual partners could increase the risk of HPV infection and associated Head and neck cancers. 80 % oropharyngeal cancers in western countries can be attributed to HPV, while in India the figures are at 20%. This difference is mainly due to sexual liberation being more common in the west.
Studies have shown that Non-smoking men who had five or more oral sex partners have a higher risk of developing HPV related oropharyngeal cancers. This risk increases in men with five or more oral sex partners and who smoked also. It means that Smoking and HPV infection has a sort of multiplicative effect in the causation of such cancers.
The risk of transmission of HPV is more common from women to men. This has been attributed to the thinner, moist skin of women’s genitals to concentrate HPV more compared to thick, dry skin of penis. So some studies suggest that the risk of developing HPV related head and neck cancers is more in individuals having oral sex with multiple female partners compared to those who have more male partners. The risk is much lower among women, anyone who did not smoke, and people who had less than five oral sex partners in their lifetimes, said Dr Prateek Varshney.
He further added approach for such patients is quite different in India as compared to the western world. Indian population is not very comfortable discussing their sexual habits. It’s difficult to study the prevalence of head and neck cancers caused due to such sexual practices in India. But considering the increasing numbers of such cancers in individuals with no history of smoking, tobacco and alcohol suggests that HPV related oropharyngeal cancers are increasing in India. Screening for such individuals is also quite difficult in our country compared to western countries. More over there is no screening test available to detect the individuals at risk to develop HPV related cancers. So in order to prevent the increase in prevalence of HPV related cancers in India, we need to educate our population especially the youth about the safe sexual habits, use of condoms and maintenance of personal hygiene. Vaccination against HPV should be given both to boys and girls before being sexually active.
To conclude, HPV related head and neck cancers is a growing disease entity with strong ties to sexual behaviour. We need to make our population aware about it so that we can prevent it and treat at an early stage
