Despite the availability of highly effective vaccines, oral human papillomavirus infections are on the rise in the United States, with low vaccination rates and unprotected oral sex driving a surge in human papillomavirus-related oropharyngeal cancers, according to a recent editorial.

Human papillomavirus (HPV), the most prevalent sexually transmitted infection in the United States, is the etiological agent in approximately 70% of oropharyngeal cancer cases, according to the Centers for Disease Control and Prevention. Current data indicated that oral HPV infection affects approximately 3.6% of women and 10% of men—figures that are likely underreported due to gaps in vaccination. The rising incidence of oral sex, particularly without protective measures, has been identified as a potential factor in the increased transmission of oral HPV and the subsequent rise in oropharyngeal cancer cases.

The editorial, published in the International Journal of Gynecology & Obstetrics, reported a significant rise in oral HPV infections in the United States. Each year, about 14 million new cases of HPV are identified in the United States. Despite the proven efficacy of the HPV vaccine in preventing HPV-associated malignancies, national vaccination coverage remains insufficient, contributing to the observed increase in HPV-related oropharyngeal cancers. 

The report also highlighted the availability of three prophylactic HPV vaccines which are highly effective in preventing HPV-related cancers when administered prior to the initiation of sexual activity. However, barriers to vaccine uptake persist, including misconceptions about the vaccine being gender-specific, the relatively high cost, and challenges in reaching the adolescent population. These barriers have contributed to suboptimal vaccination rates and, consequently, the increasing prevalence of HPV-related oropharyngeal cancer, hypothesized researchers.

There is a pressing need for comprehensive intervention to tackle the growing number of oral HPV infections in the United States, which is linked to the rise in risky oral sex practices. Increasing vaccination rates, correcting misconceptions, and addressing disparities are essential, given HPV's major role in causing oropharyngeal cancer, concluded study authors.

Full disclosures can be found in the published editorial.