Brian, regarding the statistics about oral cancers attributable to different causes (smoking vs. HPV vs. no known cause), are the sample data for those coming out of Johns-Hopkins along with other places (which I know aren't all that many) which routinely test for HPV when there is no smoking history or--like in David's case--a history of smoking but only decades ago and for a couple of years? I gather not all cccs do this test, especially since it makes no difference in treatment right now.

I'm just wondering about a possible self-selection bias in the sample leading to those percentages because it sure seems to me that there are over 5% of people here on this board that have had oral cancer on the lateral tongue (not a location associated with HPV) and had no or only a distant history (like David's) of drinking/smoking. Most of the peoploe I have met here who fall into that category are women too. And I recall a conversation several of us had (most of whom fit in that description) where we each had a chronic tooth irritation at the site of our cancer before the cancer. It just makes me think that maybe irritation can be a cause for a small group of people and that doesn't come out as a significant factor because it's hiding in the other factors.

It seems to me that the sample of people who go to J-H for treatment may not represent fairly the population of OC population. They draw local folks, and then they draw people who come from afar because of their reputation and rankings in treating OC. Well who can come from afar? Are they more likely to be male (because men, even if they have kids, can usually more easily leave those kids in the mother's care if they go for treatment)? Are they more likely to be younger? To be older?

I don't know, but I guess before I totally by into what percent of the OC population has a disease caused by HPV vs. smoking vs. other unknown things I would want to know that the sample matched the overall population in important demographics. I assume that is an analysis that has been done at some point?

BTW, related to the original question, in terms of my own history, I did smoke for over a decade but I had quit completely for almost a decade when I was diagnosed. I never drank more than a glass of wine or two a week except maybe back in college when, like most college students, I did have a few too many beers from time to time. I think people who ask the question are asking to make themsleves feel safe and I don't think it's an educational moment to tell them "yes, I smoked but I quite a decade before I got the cancer" since that would imply to anyone who does smoke that there is no point in quitting. I bascially find the way people ask that question annoying usually, although I answer honestly. As everyone else has said, it is probably something genetic in my case there as well that caused the cancer (I say this with more certainty since I have had two kinds of cancer in my 40s).

I am quite outspoken about the benefits of the HPV vaccine, however, espeically in this area where there is a lot of distrust of the pharmaceutical industry around this issue.

By the way, right now, I'd be really happy if we could just come up with a viricide for the common cold! I have been up coughing and sniffling for two nights.....