HPV-related throat cancers are rising in men, doctors say | Louisiana Health
Michael Hamilton developed a lingering cough in June 2023 that would no go away. Hamilton, 72, knew something was wrong.
He visited his ear, nose and throat doctor, Dr. Ben Walton, who said his vocal chords looked strained. Walton’s advice, according to Hamilton, was to limit talking and revisit in a months time.
“It did not go away,” Hamilton said.
His next appointment included a CT scan that led to a scope and a biopsy at Mary Bird Perkins Cancer Center.
He was diagnosed with throat cancer in January 2024. Hamilton never smoked. He never drank beer, wine or mixed drinks. He never drank coffee.
He was “baffled” by his diagnosis, he said. However, in many cases, like Hamilton’s, these cancers can occur in nonsmokers
Throat cancers, including larynx and oropharyngeal, account for roughly 3% of malignant cancer in U.S., with more than 60,000 new cases annually. Incidence rates are also rising, according to the American Cancer Society, driven by human papillomavirus-associated oropharyngeal cancer, particularly in men over the age of 55.
“We’re not sure yet why incidence rates are going up,” said Dr. William Vernado, a medical oncologist and Hamilton’s doctor at Mary Bird Perkins Cancer Center in Baton Rouge.
Dr. William Vernado, a medical oncologist and Hamilton’s doctor at Mary Bird Perkins Cancer Center in Baton Rouge.
Head and neck cancers, a broader grouping of cancer types, includes diseases starting from the lips through the larynx and windpipe. HPV-related head and neck cancers occur in the oropharynx, the back of the tongue in the tonsils.
While the vast majority of head and neck cancers are attributed to smoking, the majority or oropharynx cancers are driven by HPV — the virus can remain dormant for years and ultimately cause enough inflammation to form cancers.
Rates of HPV-related throat cancers are higher in men, primarily because women typically receive vaccinations and regular checkups for HPV as it pertains to cervical cancers. This regular, watchful eye has not yet translated to the male space, according to Vernado.
“We expect, hopefully, for the incidence to go down over the next 10 to 15 years,” Vernado said. “Because children who grew up with the HPV vaccination growing up will reach the age where these cancers are common.”
However, national skepticism over vaccines could halt any potential progress to be seen over the years.
Cervical cancer rates continue to fall
The rate of new cervical cancer cases in the U.S. has fallen significantly over the last three decades — from 11.1 per 100,000 people in 1992 to 6.9 per 100,00 in 2022.
The American Society of Cancer attributes the decreased incidence rates to increased cervical HPV screenings that have been normalized across the country and regular HPV vaccinations in children.
HPV vaccination coverage stalled in 2023 for the second consecutive year, according to a study from the Centers for Disease Control and Prevention. HPV vaccine coverage already lags most other routine vaccines.
In 2023, about 77% of adolescents, ages 13 to 17, received at least one dose of HPV vaccine and about 61% of teens were up to date on HPV vaccination, including 64% of females and 59% of males.
Nearly all cervical cancers, developed in the lower part of the uterus, are caused by persistent HPV infection and are preventable. Each year in the U.S. 13,000 new cervical cancer cases are diagnosed with Louisiana among the highest cervical cancer death rates in the country.
Cervical cancer rates have declined by 11% each year for women ages 20 to 24, “reflecting the first signs of cancer prevention from HPV vaccination,” according to the American Cancer Society.
Dr. David Barrington pictured at Ochsner Medical Complex on Friday, January 23, 2025.
Both men and women are recommended to receive their first HPV vaccination as early as age 9.
“The idea is to initiate vaccination before any sexual intercourse or potential exposure to HPV,” said Dr. David Barrington, a gynecologic oncologist at Ochsner Health in New Orleans. “We’re getting more and more data that even one dose of the HPV vaccine (without a booster later in life) is effective at preventing any infection.”
Beyond vaccination, regular screening has greatly benefited female HPV-related cancers to slow the incidence of the disease.
Men, however, should be aware of the HPV-related cancer symptoms in the body including lumps in the throat, genital warts or skin tags.
“I do not have enough kind words to describe the care I received and the compassion shown by the doctors, nurses, technicians and support staff at the Mary Bird Perkins Cancer Center,” Hamilton said.
After 33 radiation treatments, six chemotherapy visits, a blood transfusion, a feeding tube in his stomach, a nine-day stay in the hospital, losing 70 pounds and many treatments for dehydration, Hamilton is cancer free.
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