Human Papillomavirus and Oropharyngeal Cancer (FAQ)

What is HPV and how is it connected to throat (oropharyngeal) cancer?

HPV (human papillomavirus) is a very common virus—so common, in fact, that nearly all sexually active people will contract it at some point in their lives. Most of these infections are harmless and go away on their own. However, certain “high-risk” HPV types (especially HPV-16) can cause cancers.

While HPV is most often associated with cancer of the uterine cervix, it is now the leading cause of oropharyngeal cancers, which affect the palatine tonsils and the base of the tongue. These are known as HPV-positive oropharyngeal squamous cell carcinomas (HPV+ OPSCC). Unlike cervical cancer, which affects only women, oropharyngeal cancer can develop in both men and women—though it is significantly more common in men.

Over the past two decades, HPV-related oropharyngeal cancers have increased dramatically worlwide. In fact, HPV now causes more head and neck cancers than uterine cervix cancers in the U.S. and many European countries.

How do people get HPV in the mouth or throat? Is oral sex the cause?

Yes, oral sex is the primary route of transmission for HPV to the oropharynx.

HPV is transmitted through intimate skin-to-skin contact. While genital-to-genital contact can cause genital HPV, oral-genital contact can expose the throat to the virus.

Also, many patients wonder: “I’ve only had a few partners” or “I’m in a monogamous relationship—how is this possible?”

The answer is: HPV can lie dormant for years or even decades. You may have acquired it from a previous partner, and there’s no reliable way to know when or from whom. Its presence does not imply promiscuity, infidelity, or blame.

Is it common to have HPV in the throat? Will I always have it once I’m infected?

Yes, it is common—but usually transient.

Studies show that 7–10% of adults may have detectable oral HPV at any given time. The vast majority of these infections clear within 6 to 24 months without causing any problems. Only a small percentage of infections persist. And of those, only a small subset will go on to cause cellular changes that lead to cancer—often years or decades later.

We do not fully understand why some people clear the virus and others do not, but immune response, genetics, and lifestyle factors (like smoking) may play a role.

So, having oral HPV does not mean you will develop cancer. Unlike cancer of the uterine cervix, there is currently no scientific basis for routine HPV testing in the oropharynx.

What are the signs of HPV-related oropharyngeal cancer?

Most early HPV+ oropharyngeal cancers cause no symptoms. That’s why they are often diagnosed only once a lump appears in the neck—due to spread to lymph nodes.

When symptoms do occur, they may include:

• A painless neck mass or swollen lymph node
• Persistent sore throat or ear pain
• Difficulty swallowing
• Hoarseness or changes in voice
• A sensation of something stuck in the throat
• Unexplained weight loss

These symptoms are not specific to HPV or cancer, and many are caused also by benign conditions. Still, if they persist for more than 2–3 weeks they warrant medical evaluation (see your Otolaryngologist).

Can I pass HPV to my partner through oral sex or kissing? Should I change my sexual behavior if I have HPV or have had HPV-related cancer?

This is one of the most emotionally difficult areas for patients—and it’s important to be clear and compassionate.

If you are in a long-term, monogamous relationship, there is no need to change your sexual practices. Your partner has likely already been exposed (and requires no particular testing). There is no recommendation for couples to use protection or limit intimacy based on HPV status once cancer has been diagnosed.

There is no evidence that HPV-related oropharyngeal cancer patients pass on cancer-causing virus strains after treatment.

For new partners the picture is more complex. Although oral transmission of HPV can occur, the overall risk remains very low. Even in cases where transmission happens, the chance of it progressing to cancer is extremely rare. Current scientific evidence does not support the need for additional protective measures beyond the usual, sensible precautions.

Can the HPV vaccine prevent oropharyngeal cancer? Should adults get vaccinated?

Yes—and this is one of the most promising areas in cancer prevention.

The HPV vaccine protects against various HPV types, including HPV-16, the major cause of oropharyngeal cancers. While it was originally approved for preventing cervical and genital cancers, evidence strongly suggests it also prevents oral HPV infection.

Key points:

• Vaccination is most effective before any sexual exposure, usually given at age 11–12. In most of the developed countries it is already universal in the vaccination calendar (both for boys and girls).
• It is now approved for all people up to age 45.

While vaccination does not treat existing HPV infections, it may prevent new infections with other types. So yes, adult vaccination (for those not previously vaccinated) is still worthwhile, particularly for those with new or multiple partners.

Unfortunately, screening for oropharyngeal HPV infection is not currently available or recommended, so prevention through vaccination remains our best tool.

HPV is a widespread virus and a well-established cause of oropharyngeal cancer. However, the likelihood of an HPV infection leading to cancer in any given individual is extremely low.

These cancers are often highly treatable, and HPV-related cases generally have a favorable prognosis.

While it’s important to stay informed, much of the information found online might be outdated or inaccurate. For clear, current, and medically sound guidance, consult your doctor or contact our team.

J Granell. July 5, 2025.