Most of what we know about this is derived from the cervical cancer model, and while there are some correlations that can be made, the science of what happens in one anatomical structure when compared to a completely different one is not a straight across transfer. In oral we are looking at heavy involvement of lymphoid cells which are not the same kind of cells that are on the cervix. Even the two year clearance point which is a reference made often is related to cervical, we have no clue that I am aware of in oral that it is the same. One study took a cursor look at this, (NHANES). We all just suspect that the immune system deals with both in the same ways, and the same amount of time.

So this is again a demonstration of how far behind we are in understanding HPV16 itself, and working from the data which is all related to a different anatomical site with different characteristics. We can't scientifically assume with absolute certainty that it all behaves the same, so in the absence of hard data, we make scientifically based GUESSES.

Another example is the decades of dormant or latent development of a cancer so frequently mentioned by doctors in the media. We know that some viruses behave this way- but others do not. People like Posner and others are speculating when they say this because it seems to make sense. But there are no existing science articles that prove this in HPV the way we can prove it in HSV-1 for instance. When in its dormant state we can go find it living on the ganglion of your nerves. HPV -no clue. So there is a lot of scientific supposition and speculation, that may very well be right, but if there is a dormancy period after an early 20's exposure how do we account for the 20 year olds that re getting an HPV+ OPSCC? Absolutes in cancer should never be used. There is also some logic socially to support this idea. Maximum sexual partners and exposure happens in late teens and twenties. After that, people usually end up in stable monogamous relationships limiting their exposure - but late 40's is a peak for cancer coming to light. That would be a good argument for dormant period of development. But remember no hard science to support any of this.

Posner has also promoted the idea of self inoculation. Someone transfers a virus from their genitals to their mouths. Interesting idea.... not one shred of evidence that suggests this actually occurs. Doctors that are talking heads in the media get lots of weird and off the cuff questions, which some attempt to answer on the fly. When they do that, even if they are a knowledgable treating doctor, they sound authoritative on TV, but at the end of the day in the science community they are frowned on for going to where there is no evidence and speculating as if it were fact. Sometimes it is best not to worry so much about being thought of in the media as the "go to guy" to get your name out there more (some of these doctors actually have agents which work to get them bookings) than to just say we don't really know for sure when the reporter wants an answer that has meat on it. The difference in all these doctors in my mind is that if you have your name on a peer reviewed journal document, you are the real deal. Otherwise you are just another TV talking head. Said with respect for these guys that are constantly being put on the spot, by someone who, as a lay person, has no problem with stating that I don't know in public. After all I'm just another guy, not a doctor that should know what's what.

There is a lot of data on cervical, not so much on oral.