Can French Kissing Cause Cancer?

For a long time, smoking has been clearly linked to causing a variety of cancers including many in the head and neck. However, with improved public awareness campaigns, there has been a decrease in the number of people using tobacco. This has led to a decrease in the number of patients developing most, but not all forms of head and neck cancers.

Medically speaking, the head and neck is divided into different areas:

• Mouth (oral cavity)
• Throat (oropharynx and hypopharynx)
• Voice box (larynx)
• Back of the nose and sinuses (nasopharynx and paranasal sinuses)

One area of the throat that deserves special attention is the oropharynx. This region includes the tonsils and the back of the tongue. Despite decreasing rates of smoking and decreasing rates of head and neck cancer as a whole, there has been a dramatic rise in the number people presenting with cancers of the tonsils and back of tongue.

Research suggests that even open mouth kissing or “French” kissing is a risk factor for passing the virus.

These cancers more often occur in younger individuals who have no history of tobacco or alcohol use. Research over the last 10 to 15 years has revealed that these cancers are associated with infection by the human papillomavirus (HPV). HPV is known to cause cervical cancers in women and is also associated with anal and penile cancers in men. We are now seeing HPV in the majority of cancers of the tonsil and the back of tongue.

Head and neck cancers related to HPV infection are on the rise, but the reason is not clear. Numerous studies have demonstrated that this is a sexually transmitted disease. The risk of developing an HPV associated cancer of the head and neck is related to both the number of sexual partners and the types of sexual behaviors of an individual. Research suggests that even open mouth kissing or “French” kissing is a risk factor for passing the virus.

The rapid rise in HPV associated cancers of the head and neck over the last 10 years may be related to changing cultural attitudes toward oral sex. A recent study published in the Journal of the American Medical Association (JAMA) received well-deserved media attention. The study revealed that 7% of Americans are infected with HPV. In this study men were found to have a higher rate of infection at 10% than women at 4 percent.

The risk of infection was directly related to an individual’s number of sexual partners. There are many different strains of HPV and a small subset have been associated with cancer. The strain most commonly associated with head and neck cancer is HPV-16 and in this study, 1% of the population tested positive for this strain.

There are two silver linings to the story of the emergence of HPV associated head and neck cancers. The first is that these cancers are more treatable than traditional head and neck cancers associated with smoking. Multiple studies have demonstrated significantly improved cure rates. The second is that there are two vaccines for HPV on the market that have been approved for use in males and females. While studies need to be completed to verify that this vaccination is protective for head and neck cancer there is good reason for optimism.

Reference for statiscts in this blog can be found in the following article: Gillison ML, Broutian T, Pickard RK et al. Prevalence of Oral HPV Infection in the United States, 2009-2010. JAMA. 2012;307(7):693-703.

Aaron Wieland, MD
Head and Neck Surgical Oncologist
The Nebraska Medical Center

Call 800-922-0000 to make an appointment with Dr. Aaron Wieland. For clinic location and hours use the Find a Physician link.

Comments

[JEANN CHRISTOFFERSEN]

I HAVE A FRIEND (IN HER 70'S) IN CALIFORNIA WHO TOLD ME SHE HAD CANCER IN THE NOSE AND IN THE TOP PART OF HER MOUTH. THEN SHE INFORMED ME SHE HAD LUNG CANCER.
THEY TOOK HER UPPER RIGHT LOBE DURING SURGERY. WOULD ONE OF THESE CANCERS LEAD TO HAVING OTHER CANCERS? IS THIS WHAT THE EMAIL IS ABOUT?

THANKS FOR THE EMAIL AND FREE CLINICS FOR SOMETHING I HAVE NEVER KNOWN ABOUT.

[Aaron Wieland, MD]

Thank you for your interest in the blog and your comments. It is possible for cancers of this type to travel to the lungs. Cancers related to the HPV virus are probably less likely to travel to other areas of the body than are head and neck cancers associated with smoking. Because smoking is known to contribute to both head and neck cancer and lung cancer it is also possible for individuals who use tobacco to get two different cancers in different areas of the body.