Oral sex and throat cancer?

Originally Published: June 7, 2013 - Last Updated / Reviewed On: May 8, 2012
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Hi Alice,

I just read that oral sex has passed smoking in causes for throat cancer (in men more so than women). Now most of these studies link to the number of partners, but I was wondering, what if I am in a monogamous, healthy, wonderful relationship?

My fiancé and I got worried after reading the article and didn't know if we should cut down. We are each others first partners and we just were not sure of the validity of this research, especially since some of it was funded by Merck, the maker of the HPV vaccine. Can I keep going down on her? Can she keep giving blowjobs, and is it okay still for her to swallow? The reason we are so anxious is we haven’t had vaginal intercourse and this is our only form of sexual reciprocation for now until marriage. Please help!

-Desperate To Go Down

Dear Desperate to Go Down,

First off, it is important to note that it is the human papilloma virus (HPV)  itself — not the act of oral sex — that has been associated with increased risks of throat cancer. The reason why oral sex and throat cancer are associated is because HPV can be passed through oral sex. One of the risk factors for contracting HPV (whether orally, vaginally, or anally) is having a higher number of sexual partners. Now, in terms of whether you and your fiancé can continue orally pleasuring each other, the answer is yes! Carry on, do your thing, etc. The question now becomes, what safer sex precautions can you take during oral sex to remain HPV and STI free?  

You mentioned that you and your fiancé are each other’s first partners and that you are in a monogamous relationship. Given these two factors, there’s very little chance that either of you have or had previously contracted the HPV virus (or any other STI for that matter). You cannot transmit HPV through oral sex if you don’t have it. If you both remain monogamous and continue pleasuring each other in the same way, the risk of contracting HPV and other STI’s remains very, very low. To practice safer sex (and perhaps for a little peace of mind), using a condom or dental dam during oral sex can greatly reduce the risk of transmitting HPV or other STIs. If you are a Columbia student, check out the safer sex supplies map for resources available on campus. For a more in-depth look at practicing safer sex, check out the Safer Sex section in the Go Ask Alice! archives. While you are at it, check out the HPV section in the archives for specific information on HPV, including information on the HPV vaccine.  

With regards to the research findings that you mentioned, HPV is considered an established risk factor for head and neck cancers. Both alcohol and tobacco use are also risk factors. What's not clear is the relationship between the three. Is HPV a risk factor independant of alcohol and tobacco use? The research just isn't clear yet. What has been demonstrated is that, among those with head and neck cancers, those who also have HPV have a higher survival rate. Study results showed that HPV-16 (a specific viral strain of HPV) was present in the tumors of 72% of oropharyngeal cancer patients enrolled in the study. Therefore, people with HPV antibodies in their blood were 58 times more likely to have these oral cancers. Fortunately, these researchers also found that these cancers had high survival rates. Merck did not fund this study, so there is little concern about researcher bias influencing the study results.

HPV infection can go without symptoms for years after infection. As a result, many people can pass HPV to their partner without even knowing that they have the virus. So, it is important to note that a lack of symptoms does not guarantee that you or your partner is HPV-free. The best way for women to check their HPV status is to have a Pap smear, which checks the cervix for irregular cells that may have resulted from HPV. Unfortunately, there is not yet an approved HPV test for men (one reason it may ease your mind to reach for a condom or dental dam when going down orally). On the positive side, most people with HPV do not develop health problems from it. In fact, in 90% of cases, the body’s immune system clears HPV naturally after two years.

So, now that you are in the know, may your sexy adventures remain pleasurable, safe, and ever-fulfilling!

Alice