Author: Matthew Shinkle

High-risk sexual behavior may not be the primary contributor to the development of oropharyngeal squamous cell carcinoma, according to data published in Cancers.

Although patients with oropharyngeal squamous cell carcinoma appear more likely to self-report having their first sexual intercourse before age 18 years, study findings did not show an association between high-risk sexual behavior and the disease, researchers wrote.

“The consistent absence of high-risk sexual behavior in the overwhelming majority of HPV-driven oropharyngeal squamous cell carcinomas stands against the argument of a lowered frequency of HPV-driven oropharyngeal squamous cell carcinoma in our cohort … that would have lowered the chance to detect an impact on high-risk sexual behavior on the development of HPV-driven oropharyngeal squamous cell carcinoma,” Gunnar Wichmann, PhD, head of the ENT ResearchLab at University of Leipzig Medical Center, and colleagues wrote.

Background and methodology
Certain studies have provided evidence to establish a potential link between high-risk sexual behavior, the persistence of HPV DNA in saliva and the presence of oncogenic high-risk HPV subtypes in oropharyngeal squamous cell carcinoma.

Researchers conducted a case-control study of patients with oropharyngeal squamous cell carcinoma and propensity score-matched unaffected controls from a large population-based German cohort study.

The investigators interviewed patients and provided them with questionnaires on main risk factors — including age, sex, tobacco smoking and alcohol consumption — as well as logging information regarding sexual behavior categories.

The study included 329 patients with head and neck squamous cell carcinoma, of whom 317 patients answered more than 50% of questionnaire items.

Researchers performed propensity score matching of 112 patients with head and neck squamous cell carcinoma and 303 controls.

Results, next steps
Patients with oropharyngeal squamous cell carcinoma appeared more likely to self-report their first sexual intercourse occurring before age 18 years, but no differences in frequency of having casual sex or condom use compared with controls.

STDs appeared more common among controls; however, researchers determined such data not to be significant.

Results showed no association between oropharyngeal squamous cell carcinoma and high-risk sexual behavior, neither for the number of oral-sex partners or vaginal-sex partners, as researchers noted that the lifetime numbers appeared significantly lower in patients with oropharyngeal squamous cell carcinoma.

Instead, researchers determined smoking and drinking to be potentially more dangerous risk factors for disease that should be monitored early in life.

“Our research points to a set of risk factors for oropharyngeal cancer that can be prevented,” Wichmann said in a press release. “These include smoking and drinking large amounts of alcohol on a daily basis. Protection can also be achieved by vaccinating both sexes against HPV as early as possible.”

Link between oropharyngeal cancer and sexual behavior (press release). Available at: Published July 14, 2023. Accessed July 20, 2023.
Wichmann G, et al. Cancers (Basel). 2023;doi:10.3390/cancers15133356.