My work recently took me to the Multidisciplinary Symposium on Head and Neck Cancer. Among the proceedings was a discussion of the epidemiology of oropharyngeal cancer—cancer of the throat. Historically, this tumor typically occurred in people with long histories of smoking and drinking. Treatment brings the prospect of disfiguring surgery, although the surgeons do great work these days, and/or a 6-7 week slog of radiation treatment, often with chemotherapy as well, and the risk of lifelong dry mouth and aspiration pneumonia, among other things.
But lately, throat cancer has a different cause—human papilloma virus, or HPV, the virus associated with cervical cancer in women, and other, less-common cancers. HPV-related throat cancer is a sexually transmitted disease. I don’t want to be indelicate here, but the mode of transmission is—ahem—oral sex. And as one might expect, men (especially white men) are at greater risk, and the risk goes up directly with the number of (principally female) partners. There are a number of things not yet fully understood, and HPV-related throat cancer has a better prognosis than smoking-related disease and may not need quite as aggressive treatment, but one still does not want to get it. And the incidence is increasing sharply. It’s sort of an epidemic in the U.S. and elsewhere. Onset of the disease in one’s 40’s or 50’s, sometimes earlier or later.
Of course, one can control and greatly limit, if not eliminate, this risk by choice—specifically, chastity before marriage and monogamy afterward. And so would and did we, like many fellow religious conservatives, raise our sons, with that council. Or, there are vaccines, like Gardasil, initially introduced with reducing girls’ risk of cervical cancer in mind. The Centers for Disease Control and Prevention recommend vaccination at age 11 or 12.
Now, I do not intend to re-litigate here issues over vaccination like government pressure, safety (my impression is that the HPV vaccines don’t have great risks), and the like. And, frankly, I’m more inclined do urge vaccination for infections for which exposure can’t be so reliably controlled, with potentially devastating consequences (meningococcal disease, whooping cough).
But the public health people look at behaviors across populations, not of individuals, and given that I have heard tell that some religiously-raised kids think of oral sex as “Christian sex,” reflecting on the increasing incidence of HPV-related throat cancer leads me to think that more parents than otherwise would might want to give vaccinating their sons more than a passing thought.