Can Oral Sex Cause Throat Cancer? Here’s the Honest Answer

Here’s something that most people don’t know, and by the time they find out, it’s too late.

Yes, oral sex can be a route of transmission for a virus that causes throat cancer. Let’s break down that headline and understand that it’s actually a bit more nuanced than that.

The Virus in the Room: What is HPV?

What you need to know about the link between oral sex and throat cancer is one thing: The Human Papillomavirus, or more commonly known as HPV.

• HPV is the most common sexually transmitted infection in the world
• There are over 100 types of HPV – most are harmless and clear on their own
• 14 high-risk types are linked to cancer
• About 40 types can spread through direct sexual contact to the genital areas, as well as the mouth and throat.
• HPV 16 is the strain most strongly associated with throat cancer, specifically a type called oropharyngeal cancer

What is Oropharyngeal Cancer?

Oropharyngeal cancer (OPC) is a cancer that develops in the oropharynx – the middle part of the throat, which includes:

• The tonsils
• The base of the tongue
• The soft palate
• The back wall of the throat

OPC is now the most common HPV-associated cancer. Cases have been rising steadily since the 1980s and have more than doubled in men over the past two decades.

How Does Oral Sex Cause Throat Cancer?

Here is the chain of events, kept simple:

• HPV lives in the skin and the mucous membranes of the mouth
• During oral sex, the virus can transfer from the genitals to the mouth and throat
• Oral HPV16 infection is the cause of HPV-related OPC in more than 90% of cases and is primarily linked to oral sex 
• Most people who contract oral HPV will clear it naturally within one to two years
• In a small number of people, the virus persists and begins to alter DNA in the throat tissue
• Over years, sometimes decades, this can develop into cancer

The important word there is decades. A lot of patients ask their doctors, “How did I get this? I’m in a monogamous relationship.” The answer is: “You didn’t get this now. It happened many, many years ago.”

Who is at Higher Risk?

Not everyone who has oral sex will develop throat cancer, but understanding risks is important:

• Number of partners: Having multiple oral sex partners tops the list of sex practices that boost risk for HPV-linked cancer. Study participants who reported having more than six oral sex partners in their lifetime were 8.6 times more likely to develop the HPV-linked cancer.
• Age of first exposure: A higher risk was linked to an earlier age of having oral sex, specifically under 18. 
• Smoking: Men who currently smoked and had five or more lifetime oral sexual partners had a prevalence of 14.9% for oncogenic oral HPV, compared to 7.3% for non-smokers with the same number of partners.
• Sex: Men are significantly more affected. Each year in the United States, there are about 12,000 cases of HPV-associated oropharyngeal cancers, more than 80% of them in men. 
• Deep kissing: Those who had 10 or more deep-kissing partners were more than twice as likely to have an HPV-related cancer.

Should You Be Worried?

Dr Amit believes people should be informed and aware so that they can make the right choices for their health.

Oropharyngeal cancer is relatively uncommon, and the overwhelming majority of people with an oral HPV infection will not get throat cancer.

Most HPV infections clear without any intervention. What matters is understanding the risk factors and taking practical steps.

What Can You Actually Do About It?

Get the HPV Vaccine

This is the most direct form of protection available.

• The HPV vaccine protects against mouth, throat, head and neck cancers caused by HPV and gives the body a safe way to build immune system awareness of some HPV strains.
• A 2024 study presented at the ASCO Annual Meeting found that in boys and men in particular, vaccination decreases the risk of HPV-related oropharyngeal head and neck cancers. HPV vaccination is for cancer prevention.
• The vaccine is most effective before sexual debut, but still protects unvaccinated adults up to age 45
• Gardasil 9 is the current standard, approved by the FDA

Using Protection

When used consistently and correctly, condoms can lower the chance that HPV is passed from one person to another.

Knowing the Symptoms

There is currently no routine screening test for oral HPV or oropharyngeal cancer, the way there is for cervical cancer. So knowing what to look for matters.

Symptoms:

• A persistent sore throat that does not resolve
• Hoarseness lasting more than a few weeks
• Difficulty swallowing
• A lump in the neck
• Unexplained ear pain
• Unexplained weight loss

The Bottom Line

Oral sex and throat cancer are linked through HPV, specifically HPV 16. The risk is real, but the lifetime risk remains low for most people. What genuinely changes the equation is the number of partners, smoking, and vaccination status.

Things that work in preventing throat cancer include the vaccine and using a barrier (protection). Also, knowing the symptoms means catching anything early if it does occur.

This is not a reason to panic about your sex life. It is a reason to be vaccinated, informed, and attentive to your body.

References

1. Lam P. Nguyen, Ly M Nguyen, Sroka Thomas, Bevan Hong-Ly, Alexander Chi, Paul Vos, Ulf Karlsson, Vincent Vinh-hung, the International Geriatric Radiation Oncology Group, Oral Sex and Oropharyngeal Cancer, 2016, available at, https://pmc.ncbi.nlm.nih.gov/articles/PMC4956823/ 
2. Dr Min Karen Lo, Dr Julian White, Q&A HPV and Throat Cancer, 2015, available at, https://www.ogmagazine.org.au/17/2-17/qanda-hpv-and-throat-cancer/ 
3. James A Chancellor, Sally J. Joannides, James M Elwood, Oral and oropharyngeal cancer and the role of sexual behaviour: a systematic review, 2015, available at, https://onlinelibrary.wiley.com/doi/abs/10.1111/cdoe.12255

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