Of particular concern for men in the United States is the recent rise in the number of cases of oropharyngeal cancer linked to HPV infection. Oropharyngeal cancer is cancer that develops on the back and sides of the throat, tonsils, and base of the tongue.

While it’s not known exactly why the incidence of this type of cancer is increasing, it’s believed to be the result of more people engaging in sexual activity with more partners than in years past, combined with an increase in oral sex practices. Consequently, more people have oral HPV infections, some of which put them at risk of cancer.

Heavy tobacco and alcohol use also raise the risk of oropharyngeal cancer, but they do not appear to be the cause of the upward trend in cases.

Men appear to be more likely than women to develop an oral HPV infection. About 10 percent of men and 3.6 percent of women have an oral HPV infection, which is more common with older age.

Not all oral HPV infections lead to cancer. Each year, there are about 54,000 new cases of oropharyngeal cancer, and about 11,600 people die from the disease. Those numbers represent an estimated 2.8 percent of all new cancer cases and 1.9 percent of all cancer deaths.

In 2020, an estimated 424,284 people were living with oropharyngeal cancer in the United States. The lifetime risk of developing this type of cancer was estimated to be 1.2 percent for men and women combined.

Signs and Symptoms of HPV-Related Oropharyngeal Cancer in Men

In research studies, oral HPV infections are detected by having study subjects rinse and gargle with a solution that is then examined for the presence of HPV.

But because such tests are not done routinely by doctors or dentists, oropharyngeal cancers caused by HPV are generally discovered only when they cause symptoms.

Signs and symptoms of oropharyngeal cancer include:

Persistent sore throat, hoarseness, or coughing
Persistent ear pain
Pain or difficulty with chewing or swallowing
Unexplained weight loss
A lump in the neck
Difficulty opening the mouth fully
Change in voice

Most people with oropharyngeal cancer notice a lump or mass in their neck as the first sign. If you develop a lump in your neck that lasts for longer than two weeks, see an otolaryngologist (head and neck surgeon) for an evaluation.

Genital HPV Infection in Men

American men have even higher rates of genital HPV infection than they do oral HPV, with a prevalence of about 40 percent (men and women have similar rates). More than 40 types of HPV are transmitted through direct sexual contact, including vaginal, anal, and oral sex.

Men who have sex with men are more likely to contract HPV, as are men with weakened immune systems, including those with HIV.

Genital HPV infection in men is responsible for more than 60 percent of penile cancer cases and more than 90 percent of anal cancer cases.

Genital HPV infection can also cause genital warts, with HPV types 6 and 11 being responsible for 90 percent of genital warts.

Signs and Symptoms of Penile and Anal Cancers

Penile cancer initially causes tissue changes in the penis — including changes in color and thickening of the skin — and may later cause penile growths or sores.

Signs of anal cancer include anal bleeding, pain, itching, or discharge, along with swollen lymph nodes in the anal or genital area and changes in bowel habits and stool.

If you observe any of these signs or symptoms, see your doctor.

Anal, penile, and oropharyngeal cancers caused by HPV are treated with standard cancer therapies, including chemotherapy, radiation therapy, and surgery.

Signs and Symptoms of Genital Warts in Men

In men, genital warts — which may appear weeks to months after HPV is contracted — grow inside or around the anus, on the upper thighs and in the groin area, and on the scrotum and penis, including under the foreskin and inside the urethral opening. (The urethra is the tube through which urine exits the body.)

Genital warts may be:

Clearly visible or too small to see
Flat or raised
Cauliflower-like in appearance (when they grow in clusters)
Tender, painful, or itchy

If warts grow in the urethral opening, they can cause abnormal urine flow as well as bleeding from the urethra.

The types of HPV that cause genital warts can also cause a condition called recurrent respiratory papillomatosis, a rare but life-threatening disease in which warts form in the respiratory tract, potentially blocking the airway.

Genital warts can be treated with various self-applied or doctor-applied topical medications. Surgical treatment may be required for difficult-to-treat warts.

Preventing the Spread of HPV in Men

The most effective way for anyone to prevent getting genital warts and HPV-related cancers is to get the HPV vaccine at the recommended age.

Gardasil 9, the HPV vaccine currently available in the United States, protects against HPV types 16, 18, 31, 33, 45, 52, and 58, all of which can cause cancer, as well as types 6 and 11, which cause genital warts.

All young people should get the HPV vaccine at age 11 or 12. If you didn’t get the complete series of vaccines at that age (or earlier), you can still get it through age 26.

The HPV vaccine is also approved for adults up to age 45, based on a discussion with your healthcare provider about whether it makes sense for you.

For men of all ages, limiting your number of sex partners can lower your exposure to HPV, and using condoms or dental dams during sex is partially protective against HPV infection.

A new type of underwear made of stretchy latex and designed to prevent sexually transmitted infections during oral sex may provide another option. It was cleared by the U.S. Food and Drug Administration in May 2022. While men can wear these protective undergarments, they are sized primarily for women.

Additional reporting by Quinn Phillips.

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