IS ORAL SEX A RISK FACTOR FOR ORAL SQUAMOUS CELL CARCINOMA; AN IGNORED RESEARCH QUESTION IN INDIA
Michael Douglas, Hollywood Star makes a statement to British Newspaper that Human Papilloma Virus (HPV) transmitted through oral sex led to his throat cancer. This statement sends shivers down the spine of all oral health care providers in India. When investigated further in 2006 in New England Journal of Medicine had quoted that a high number of oral sex partners in a life time is associated with an increased risk for oropharyngeal cancers. Scientist says that 64% of cancers of oral cavity, head and neck in the United States are caused by HPV which commonly spread via oral sex. A study at Ohio State University quotes that an individual with six or more life time partners on whom they have performed oral sex has an eight-fold increased risk compared to someone who had never performed. Western literature says oral sex is the commonest cause for oral cancer than tobacco.
India has the highest rate of oral cancer among men. Though in India oral cancer is associated with smoking, drinking and chewing of betel nut, HPV is also implicated in a few cases. Cervical cancer is the most common cancer among women in India and HPV is the foremost cause for cervical cancer. Is oral sex the connecting link between these two different locations? Are we sitting on a ticking bomb? Future research aimed at the correlation between cervical cancer in women and oral cancer in men would throw light on the above hypothesis.
Though oral sex has been part of the sculptures and scriptures of ancient India during Vedic period it became a taboo in the later period where India transformed to a more conservative society and practice of oral sex could not be a factor in oral cancer then. But now with the economy doing well and life style of an average Indian having changed and the habit of aping the west being considered cool among youngsters, oral sex has become a common thing amongst them. But these youngsters have to be made aware of this deadly virus. When we talk about sex or sexually transmitted diseases in India we usually think of AIDS or other venereal diseases but with over 6 million Indians travelling abroad and about 10 million foreigners visiting India, oral sex could be the fore most causative agent for oral cancer in India.
When a rape happens in India thousands of youngsters flock the road demanding justice, the media talks about sex education in schools and pre-university syllabus. Unfortunately the significance of the devastating effect of HPV is not being highlighted. Media, the government and health professionals should focus on healthy sexual habits for the public, especially amongst the youngsters.
As oral pathologists we have the highest responsibility, yet have not highlighted oral sex and its relationship with oral cancer in any of our literature. The few articles that have come of late have come from the western literature have brought up this connection but much more is needed to be done. Before educating the public, oral health professionals should be educated about oral sex and its association with oral cancer.