HPV and Oral Cancer
HPV-16 is now the leading cause of throat cancer in the US — overtaking tobacco. Here's what that means, who's at risk, and what you can do.
Human Papillomavirus (HPV) has overtaken tobacco as the leading cause of oropharyngeal cancers — cancers of the tonsils, base of tongue, and back of the throat. Cases have risen by more than 300% since the 1980s.
What is HPV-related oral cancer?
HPV is a common sexually transmitted virus. Most infections clear on their own without symptoms. In some people, however, certain strains — especially HPV-16 — cause changes in cell DNA that can eventually lead to cancer.
HPV-related oral cancers typically develop in the oropharynx: the tonsils, the base of the tongue, and the back wall of the throat. This is different from traditional oral cancers, which tend to form on the lips, gums, tongue tip, and floor of the mouth.
Because the oropharynx is hard to see and these cancers often don't cause pain early on, they're frequently caught later than other oral cancers — which is why knowing the symptoms matters.
Symptoms to watch for
HPV-related throat cancers can look a lot like a persistent cold or sore throat. The key signal is duration — symptoms that don't go away after two weeks deserve attention.
- →Persistent sore throatNot caused by infection, doesn't resolve in 2 weeks
- →Painless lump in the neckOften the first sign — caused by lymph node involvement
- →Difficulty swallowingA feeling that food is catching or not going down right
- →Ear pain on one sideCan radiate from the throat even without ear infection
- →Hoarseness or voice changesLasting more than two weeks with no obvious cause
- →Unexplained weight lossEspecially when combined with any of the above
Who is at risk?
HPV-related oropharyngeal cancer most commonly affects men between the ages of 40 and 60 with no history of tobacco use. This is one of the things that makes it easy to dismiss — people assume oral cancer is a smoker's disease.
A higher number of lifetime oral sexual partners is associated with increased risk, as HPV is primarily transmitted through sexual contact. However, HPV is extremely common — most sexually active adults have been exposed at some point — and the vast majority of infections never lead to cancer.
Tobacco and alcohol use alongside HPV infection further raises risk. Immune-compromising conditions (like HIV) also reduce the body's ability to clear HPV naturally.
The HPV vaccine
Gardasil 9 protects against HPV-16 and HPV-18 — the two strains responsible for most HPV-related cancers. It is FDA-approved for people ages 9 through 45.
The vaccine is most effective when given before exposure to HPV, which is why it is routinely recommended for preteens. But adults who weren't vaccinated earlier may still benefit — talk to your doctor.
The vaccine cannot treat an existing HPV infection, but research shows it has already begun to reduce HPV-related cancer rates in vaccinated populations.
Common questions
Can HPV cause oral cancer?+
Yes. HPV — specifically the HPV-16 strain — is now the leading cause of oropharyngeal cancers, which are cancers of the tonsils, base of tongue, and back of the throat. HPV-related cases have risen sharply over the past two decades and now outnumber tobacco-related cases in this part of the mouth.
What are the symptoms of HPV-related oral cancer?+
Common symptoms include a persistent sore throat, difficulty swallowing, a painless lump in the neck, ear pain, and hoarseness that lasts longer than two weeks. Because these cancers often start at the base of the tongue or tonsils — areas not easily visible — they are frequently caught at a later stage.
Does the HPV vaccine prevent oral cancer?+
The HPV vaccine (Gardasil 9) protects against HPV-16 and HPV-18, the strains responsible for most HPV-related cancers. It is FDA-approved for people ages 9 through 45 and is most effective before exposure to HPV. It cannot treat an existing infection, but vaccination significantly lowers the risk of HPV-related oropharyngeal cancer.
Who is most at risk?+
HPV-related oropharyngeal cancer disproportionately affects middle-aged adults — particularly men between 40 and 60 — with no history of tobacco use. A higher number of lifetime oral sexual partners is associated with increased risk. Unlike traditional oral cancer, it often appears in people with no obvious risk factors.
Is HPV-related oral cancer curable?+
HPV-positive oropharyngeal cancers tend to have better outcomes than HPV-negative ones. When caught early, survival rates are high. But many cases are found late because symptoms are easy to miss. Any symptom in the mouth or throat lasting more than two weeks deserves evaluation by a dentist or doctor.