HPV Increases Men's Risk for Oral Cancer, Prompts Calls for Vaccine: Pathology Expert Dr. Shashi Pawar on HPV Health Concerns for Men

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The human papillomavirus is one of the most insidious and dangerous sexually transmitted diseases for women, as it has been linked to a vast majority of cervical cancers. We are now seeing the effects of HPV infection in men, and the marked increase in oral cancer - coupled with the well-known increased risk for penile and anal cancers - suggests that both sexes face equally serious health consequences from this virus.

HPV, the human papillomavirus, is well known for its role in causing cervical cancer in women - so much so, in fact, that the National Institutes of Health recommend all girls be vaccinated against the virus when they are 11 or 12, prior to becoming sexually active. However, recent research shows that women are not the only ones at risk for developing HPV-related cancers. Oral cancers caused by the virus are increasing rapidly in men, and researchers suggest HPV may soon overtake tobacco use as the leading cause of these cancers of the mouth, tongue, throat and tonsils.

"The human papillomavirus is one of the most insidious and dangerous sexually transmitted diseases for women, as it has been linked to a vast majority of cervical cancers," explains Dr. Shashi Pawar, PhD, FACMG, Director of Genetics at Acupath Laboratories. "We are now seeing the effects of HPV infection in men, and the marked increase in oral cancer - coupled with the well-known increased risk for penile and anal cancers - suggests that both sexes face equally serious health consequences from this virus," Dr. Pawar notes.

Cumulative research spurs call for men's vaccine
A benchmark study that tracked more than 30 years of oral cancer data from the National Cancer Institute found that the rate of oral cancer caused by the HPV virus, rather than lifestyle habits such as smoking or chewing tobacco, has risen steadily since 1973 and is now about even with the incidence rate for tobacco use. Researchers at Johns Hopkins University, which conducted the study, reviewed more than 46,000 cases of oral cancer diagnosed between 1973 and 2004, and concluded that HPV is poised to overtake tobacco use as the leading cause of oral cancer in men.

"While researchers have not yet definitively concluded the cause in this shift, many in the medical community theorize that the convergence of two factors is to blame," Dr. Pawar points out. "The first is a decrease in tobacco use, and the second is a broadening of sexuality and sexual behaviors. Many couples, particularly younger couples, are more apt to experiment with oral sex; ironically, men and women may believe that this is actually safer than penetration in avoiding the spread of sexually transmitted diseases," Dr. Pawar adds.

Other studies reinforce, and even surpass, the NCI research. A study published in May in the New England Journal of Medicine (NEJM) reported the risk of developing HPV-related oral cancer for men and women who had multiple oral sex partners (six or more) was nine times that of participants who had no oral sex partners. What's more, those who were infected with HPV were 32 times more likely to develop oral cancer than uninfected participants, while those who smoked had only a threefold increased risk, and those who drank alcohol had only a 2.5 times greater risk.

"Because the confluence of data continues to confirm, and even expand, the belief that HPV infection is just as dangerous for men as it is for women, the call for vaccinating boys against this virus has become more vocal in recent months," Dr. Pawar explains. Merck, the makers of the vaccine (Gardasil) used to protect girls against the virus, has recently requested permission from the FDA to begin marketing the vaccine for male patients later this year.

Early detection key to survival
Nearly 29,000 new cases of oral cancer are diagnosed each year in the U.S. Of those, about 19,000 are in men, and researchers estimate approximately 40% -- nearly 8,000 - involve HPV infection. The good news is that most oral cancers respond successfully to chemotherapy and radiation regimens when diagnosed and treated in their earliest stages. Yet, many cases are not caught early enough, or are misdiagnosed - leading to improper or delayed treatment.

"The most accurate test to confirm a diagnosis of HPV infection is called In Situ Hybridization, or ISH," Dr. Pawar notes, concluding. "In studies comparing ISH to Hybrid Capture (HC) or polymerase chain reaction tests, ISH was found to be nearly three times more accurate."

About Dr. Shashi Pawar, PhD, DABMG
With over twenty years of varied experience in molecular genetics and molecular pathology, Dr. Shashi Pawar serves as the director of Genetics at the Acupath Laboratories, Inc. She is American board of medical genetics certified in clinical Molecular genetics and clinical Cytogenetics. Additionally, she has published in dozens of highly acclaimed medical journals and publications, including the Proceedings of National Academy of Science and the Journal of Biological Chemistry. At Acupath laboratories Inc. Dr. Pawar implements cutting edge technology in molecular diagnostics to bring clinical diagnostics tests within easy reach of the Physicians and patients.

About Acupath:
Acupath Laboratories, Inc. is an innovative national specialty medical laboratory located twenty miles east of Manhattan in Plainview NY. Acupath's reputation is built on the foundation of our nationally recognized board certified pathologists, molecular geneticists, and cytogeneticists leaders in their fields; many have sub-specialty certification. Acupath performs only pathology, molecular and cytogenetic exams; ensuring the highest standards in the industry. http://www.acupath.com

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MELISSA CHEFEC

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