title: The role of sexual behavior in head and neck cancer: implications for prevention and therapy.
abstract: HPV-positive oropharyngeal squamous cell carcinoma (HPV-OSCC) is associated with oral sexual behaviors. The sharp rise in incidence of HPV-OSCC in the USA has been attributed to changes in sexual norms over the past five decades, with lower age at sexual debut and higher numbers of sexual partners per individual. In addition, variations in HPV-OSCC prevalence by race, age cohort and gender may be attributable to differences in oral sexual behaviors among these groups. Oral HPV infection is the putative precursor to HPV-OSCC. Risk factors for oral HPV incidence, prevalence, clearance and persistence are crucial to understanding how, and in whom, oral HPV infection progresses to malignancy. Future investigation should focus on elucidating the natural history of oral HPV infection persistence and malignant transformation, developing effective screening tools and exploring opportunities for prevention such as vaccination and public health education.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, 601 N. Caroline St, Baltimore, MD 21287, USA.
authors.forename: Eleni
authors.initials: E
authors.lastname: Rettig
authors.forename: Ana Ponce
authors.initials: AP
authors.lastname: Kiess
authors.forename: Carole
authors.initials: C
authors.lastname: Fakhry
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000517:prevention & control* / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000517:prevention & control / Q000628:therapy; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000635:transmission; D011314:Preventive Health Services; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000635:transmission
keywords: head and neck neoplasms; health education; human papillomavirus; human papillomavirus vaccines; oral sex; oropharyngeal neoplasms; sexual behavior; sexually transmitted diseases