The recent announcement, however, by actor Michael Douglas that his esophageal cancer was caused by oral sex and specifically the human papillomavirus (HPV) has brought nonenvironmental etiologies into the spotlight.
In fact, 15% to 20% of OSCCs occur in nonsmokers and nondrinkers, suggesting the presence of other risk factors.
Recent studies suggest that HPV infections of the upper respiratory area may lead to head and neck tumors.
In the cases like Michael Douglas, some experts estimate that about 14,000 throat cancers are diagnosed every year in the United States, and about 70% of those are related to HPV.
In one study, HPV presence in the oral cavity was associated with increased risk of oral cavity or oropharyngeal cancer (odds 3.7 with a 95% confidence interval), independent of alcohol and tobacco exposure.
Men with cancers at these sites also had sexual risk factors similar to those for women with cervical cancer associated with HPV infections, such as early age of first intercourse, multiple sexual partners, and a history of genital warts.