More oral cancers caused by HPV than Smoking

[Vocalek]

CTV Ottawa- HPV causing surge in oral cancer rates: doctors - CTV News

Not so long ago, the majority of patients with oral or throat cancer were older smokers or heavy drinkers. But the face of neck cancer is changing, all because of a sexually transmitted virus.
Doctors say the number of cases of head and neck cancers in young, otherwise healthy patients in on the rise in Canada.
...
Around 2,000 cases of oral cancer are diagnosed each year in Canada. The reason for the shift, doctors say, is the spread of HPV, the human papillomavirus. It's estimated that about two-thirds of cases diagnosed today are caused by HPV.

This is something to keep in mind when we are trying to counter accusations of oral cancer being caused by smoke-free products.

This page is a long list of research articles on HPV and oral cancer. However another page on the same site claims smokeless tobacco is the major cause. IMHO the jury is out. The researchers need to take a close look at oral cancers and test each case for HPV.

http://www.oralcancerfoundation.org/facts/hpv_reports.htm

Update: Went to PubMed, searching on "oral cancer HPV smokeless".

http://www.ncbi.nlm.nih.gov/pubmed/16335030

In multivariate analysis average oral hygiene (OR 2.0; 95% CI 1.1-3.6) and poor oral hygiene (OR 5.3; 95% CI 2.5-11.3), more than 5 defective teeth (OR 3.1; 95% CI 1.2-8.2) and more than 20 teeth missing (OR 3.4; 95% CI 1.4-8.5), as well as defective or malfunctioning complete dentures (OR 3.8; 95 % CI 1.3-11.4) were identified as significant risk factors for development of OOSCC. Regular dental care reduced the risk of OOSCC (OR 0.4; 95% CI 0.2-0.6). The cases reported a higher consumption of alcohol than the controls. More than 350 g of alcohol per week (OR 2.6; 95% CI 1.3-5.4) and 11-20 cigarettes per day (OR 2.4; 95% CI 1.3-4.1) were dose-dependent risk factors. The results showed a tendency for women to have a greater risk (OR 1.8) than men at any given level of tobacco consumption. There was no increased risk of OOSCC among users of Swedish moist snuff. There was a significant relationship between high-risk human papillomavirus (HPV) infection and OOSCC (OR 63; 95% CI 14-280). Forty-seven of the cases (36%) were high-risk HPV infected and 7 (5.3%) were low-risk HPV infected in the specimens collected from the oral cavity. The corresponding figures for the controls were 3 (0.94%) and 13 (4.1%), respectively. The high-risk HPV types found in the oral cavity were the same types as observed in cervical cancer.

If I am reading this correctly, in descending order the relative risks (RR) are:
High-risk HPV infection - 63
Poor oral hygiene - 5.3
Malfunctioning dentures 3.8
More than 20 missing teeth - 3.4
More than 5 defective teeth - 3.1
High alcohol consumption - 2.6
11 to 20 cigarettes per day - 2.4
Being female - 1.8
Using Swedish moist snuff - 1.0
Regular dental care - 0.4

NOTE: Relative risk uses the average risk of 1.0 for some assigned condition. In this case I believe that 1.0 represents the average risk across the entire population. If you have high-risk HPV infection, the odds of your getting oral cancer are 63 times higher. If you have regular dental care, your odds are only 4/10 of the average risk. Since I no longer smoke and get regular dental care, I guess it isn't necesary to get a sex-change operation.

 

[Vocalek]

Just came from an appointment with the Ear, Nose, & Throat specialist for both my husband and me. At my husband's last appointment, I showed the doctor my electronic cigarette. He was intrigued about e-cigs, but not so much in favor of the rest CASAA's mission--to promote smoke-free tobacco products as a reduced-harm alternative to smoking. He had seen cases of young people with oral cancer who used chewing tobacco. He had not heard of snus. I asked him to search PubMed on using "snus cancer."

Today was my appointment and the Doc told me that he had gone to 7-11 yesterday and purchased an electronic cigarette for a doctor friend who has been unable to stop smoking. I gave him a copy of the CASAA tri-fold brochure on e-cigarettes and also I printed out the complete abstract on the analysis of risk factors for oral cancer extracted above.

He has been looking into snus and said that he thought he has seen this abstract before. I highlighted the line "There was no increased risk of OOSCC among users of Swedish moist snuff." So far he is very positive about the concept of tobacco harm reduction. He didn't go so far as to say he is in favor of snus, but at least his mind is open to looking at the facts. YAY!

I told him that I have been spending a lot of time on Pub Med and am finding that the research is not corroborating a lot of the statements being made on government web sites and on sites such as the American Cancer Society and the American Lung Association. He liked the brochure and told me he thought what we are doing is great work. He said it is good that there are watch dogs like us trying to keep everyone honest.

 

[MoonRose]

Now if we could just get all these doctors, who are siding with us, to go public on TV news about the benefits of using reduced harm smokeless tobacco products and e-cigs we could start to really turn the tide on the public's acceptance of these products.