The incidence of tonsil cancer has tripled in the city of Stockholm since the 1970s and doctors at the world-famous Karolinska Institute there think they know why.

Oral sex. Or perhaps French kissing. And changes in sexual behavior that took place 20 or 30 years ago, says Tina Dalianis, a professor of tumor virology at Karolinska.

Her research has directly linked the increase in tonsil cancers to the human papillomavirus (HPV). There are more than 100 different types of HPV, some of which cause cancer. One, for example, is responsible for 99.7% of all cervical cancers.

The study found that patients with HPV in their mouths are much more likely to get tonsil cancer than patients who donít have it. In fact for patients who are HPV-positive, the rate of tonsil cancer has gone up seven times since the '70s, Dalianis says. It takes between 20 and 30 years for an HPV infection to result in cancer, so the people getting sick now were infected in the '70s and '80s.

ďItís an epidemic,Ē she says.

Prior to this, the greatest risk factor for tonsil cancer was drinking and smoking. As smoking rates have dropped, the number of tobacco-linked tonsil cancers has declined.

Researchers monitored everyone in the Stockholm area diagnosed with tonsil cancer between 2003 and 2007. Their study, recently published in the International Journal of Cancer, found that of 120 patients who got the cancer, at least 83 were HPV-positive.

Tonsil cancer is dangerous because it has almost no symptoms, so many people donít seek medical attention until it has spread to their lymph nodes and is much harder to treat.

ďIf they have a lump in their throat, especially if itís on one side and it doesnít go away with antibiotics, they should see a doctor,Ē Dalianis says.

One bright spot is that a vaccine against the cancer-causing HPV16 virus has been available since 2006 and is now being given to many girls between the ages of 10 and 12 to prevent cervical cancer. Dalianis hopes that it may help prevent tonsil cancers as well.

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