8 October 2014

New research suggests smokers are three times more likely to have an STI linked to mouth cancer, significantly increasing their risk of developing the disease.

Researchers studied 6,887 people and discovered oral HPV-16 - a cancer-causing form of the human papillomavirus (HPV) - was three times higher in current smokers compared to never or former tobacco users1. Current smokers were identified as more likely than non-users to be male, younger, less educated, and to have a higher number of lifetime oral sex partners.

The human papillomavirus, transmitted via oral sex, is believed to be behind a significant increase in mouth cancer cases. While tobacco remains the leading risk factor for the disease, many experts predict HPV will soon overtake tobacco as the main cause of mouth cancer.

The findings, presented in the Journal of the American Medical Association (JAMA), appear to confirm the theory that a person's social background could heighten their chances of developing the disease. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, hopes the findings are used to deliver better education to those who need it.

Dr Carter says: "There is an obvious target group health professionals need to reach out to. Government initiatives to tackle smokers has resulted in more adults quitting, but an increased number of young people taking up the habit.

"The same investment has been made in sex education, yet the UK still has one of the highest rates of teenage pregnancies in Europe. It is clear these messages are not getting through, which is why campaigns such as Mouth Cancer Action Month in November are crucial to transforming the health landscape of the country.Smoking or not smoking

"If more people knew that tobacco use and the human papillomavirus, as well as drinking alcohol to excess and poor diet, significantly increases their chances of developing mouth cancer, cases might stop rising."

The campaign also aims to educate the general public on the signs and symptoms of the disease in the hope they become more mouth aware, something Dr Carter feels smokers need to bear in mind.

"Ulcers that do not heal within three weeks, red and white patches and unusual lumps or swellings in the mouth are all signs of mouth cancer," Dr Carter adds. "We know less-educated people and those at the lower socio-economic spectrum visit the dentist less often, so it is important they have the information to self-examine. Our message to anyone who notices a change in their mouth is ‘if in doubt, get checked out'."

The researchers used data from the National Health and Nutrition Examination Survey (NHANES). This analysis included 6,887 participants, of whom 2,012 (28.6 per cent) were current tobacco users and 63 (1.0 per cent) had oral HPV-16 detected. Oral HPV-16 prevalence was greater in current tobacco users (2.0 per cent) compared with never or former tobacco users (0.6 per cent). Average cotinine and NNAL levels were higher in individuals with vs without oral HPV-16 infection.


1. Tobacco Use and Oral HPV-16 Infection, Carole Fakhry MD, MPH, Maura L. Gillison MD, PhD, Gypsyamber D'Souza PhD, MS, MPH, JAMA. 2014;312(14):1465-1467. doi:10.1001/jama.2014.13183