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Men are more at risk of developing mouth and throat cancer linked to oral sex, which can spread human papillomavirus (HPV), one of the most common sexually transmitted infections, which according to the U.S. Centers for Disease Control and Prevention (CDC) affects more than 90 percent and 80 percent of sexually active men and women, respectively.

A new study presented at the annual meeting of the American Association for the Advancement of Science (AAAS) on Friday showed that men have twice the risk of getting HPV-related cancers compared with women. Middle-age white men, in particular are at high risk of developing the diseases compared to men of other races.

Gypsyamber D’Souza, from Johns Hopkins University in Baltimore, said that nearly two of three of these oral cancers in the U.S. and in many other western nations can be attributed to the HPV 16 strain infection and that the risk for oral HPV increases with the number of oral sex partners that men have.

The association appears to have the opposite effect in women. The number of sexual partners does not seem to affect women’s risk for these cancers and that women who have more vaginal sex partners appear to have lower risk for oral HPV infection.

D’Souza explains that this could be because when women were first exposed to HPV vaginally, their body mounts an immune response that provides protection that prevents them from getting oral HPV infection. Men do not appear to have the same robust immune responses.

“Our research shows that once you become infected, men are less likely to clear this infection than women, further contributing for the cancer risk,” D’Souza said. The study was published in the Journal of the American Medical Association.

Although high-risk HPV infection may go away within one or two years and do not cause cancer, some cause cellular changes in the mouth and throat that if left untreated, may become cancerous. The symptoms may develop years after a person has had sexual contact with someone who is infected.

Other factors that can up risks of infection include smoking or chewing tobacco, a weakened immune system, and poor oral hygiene.

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