Don’t blame oral sex: This is the real culprit behind HPV-related cancers

I cringed when I opened my Google News app and saw this headline “Cancer: Oral sex now riskier than smoking, alcohol.” While the statement is not wrong, and there is very real data about the connection between multiple oral sex partners and cancers of the head and neck, we need to clear some things up.

Oral sex is not the boogeyman here, it’s Human Papilloma Virus (HPV). Understanding and preventing HPV has become an important topic for me as a journalist and as someone who aims to educate people about caring for their sexual well-being.

What these half-accurate headlines leave out is a critical information about HPV, which is also the leading cause of cervical cancer, a disease that still has only a 17% survival rate for late-stage diagnoses. In reality, this news about head and neck cancer has everything to do with HPV and little to do with oral sex.

I talked to sex educator Erica Smith to get the low-down on going down, and what this means for our sex lives.

Americans really like oral sex…a lot.

The Centers for Disease Control and Prevention estimates 85% of sexually active adults have engaged in oral sex at least once, and a survey published by Bespoke Medical found the average American adult gives and receives oral sex around five times per month. Bad Girls Bible surveyed over 1000 women in 2021 and found the overwhelming majority (92%) enjoying giving fellatio (performing oral sex on a penis) to their partner.

Yes, HPV is more risky than smoking when it comes to head and neck cancer, especially for men

Previously, doctors connected smoking and drinking to head and neck cancers or cancers of the back of the mouth and throat, but now HPV is the main threat.

Studies have also found men are more likely to have HPV floating around in their mouths compared to women. Women were also less likely to be diagnosed with HPV-related head and neck cancers compared to men, but they must shoulder the burden of cervical cancer–an organ most people assigned male at birth don’t have.

While the connection between men and HPV-related head and neck cancer isn’t fully understood, Dr. Jeyarajan Harishanker, an ear nose and throat (ENT) doctor at the University of Alabama at Birmingham Hospital, said it’s clear men should be concerned about HPV prevention.

“People that present with HPV related cancers I treat are generally nonsmokers. They are generally fit and healthy and have no other health issues,” he said.

The kicker: Eliminating HPV-related cancers is possible thanks to vaccines (but we still have work to do)

There is only one vaccine that prevents cancer–the HPV vaccine. If this information is making you feel a little uneasy, take a breath. This is where the good news about cancer and oral sex starts.

“The link between oral sex, HPV, and cancer does not have to mean that we don’t engage in oral sex. As with any preventable disease or illness, there are precautions that we can take,” said sex educator Erica Smith.

Women can be screened for HPV, but there is still no way to screen for HPV infection in men, so men’s best defense against the virus is to get vaccinated, she said.

Her approach to addressing this issue is focused on harm-reduction, and she said the best tool we have to reduce the harm caused by HPV is getting the vaccine. The American Cancer Society recommends boys and girls receive the HPV vaccine between ages 9-12 for best protection, as the vaccine is most effective before a person’s first sexual encounter.

The HPV vaccine is approved for people up to age 45.

“If you weren’t given the vaccine as a young person because your parents didn’t want you to have it, you can now get it for yourself- as I’ve had many clients who were raised in purity culture do. It’s a really powerful way to take control of your sexual health,” Smith said.

The American Cancer society says the HPV vaccine has the potential to “virtually eliminate cervical cancer” in America, according to its latest report on cancer in America. The report noted a 65% drop in cervical cancer among women ages 20-24 from 2012 to 2019–a datapoint that coincides with other earlier studies showing reduced rates of HPV transmission and HPV-related cancers in people who have been vaccinated.

If you’re well into your 20s and have been having sex for a few years, your chances of having been exposed to HPV are high, as 90 percent of all sexually active adults will be infected with HPV at some point in their lives. The body takes care of most HPV infections within two years, but some strains of HPV can cause cancer of the genitals, anus, mouth and throat in both men and women.

HPV and abstinence-only sex ed

Researchers have linked abstinence-only sex education with disproportionately high rates of cervical cancer in Southern states. Curiously, white teenagers are also less likely to be vaccinated against HPV, according to data from Boston Medical Center and the American Cancer Society.

The HPV vaccine is not required to attend school in most states with only Hawaii, Rhode Island and Washington D.C. requiring students receive the HPV vaccine to attend school.

A personal note

I did not receive the HPV vaccine before I had my first sexual encounter, although the Gardasil vaccine was available at the time. I decided to get the HPV vaccine last fall at the encouragement of my gynecologist, who was very glad to hear I had made the decision to protect myself from future exposure to HPV and thus, protect myself from cancer.

For more information about HPV, the vaccine and HPV-related cancers, read below:

Oral Cancer Foundation

The American Cancer Society

Mythbusting the HPV vaccine