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Biological factors include viruses and fungi, which have been found in association with oral cancers. The human papilloma virus, particularly HPV16, has been definitively implicated in oral cancers, particularly those that occur in the back of the mouth. (Oropharynx, base of tongue, tonsillar pillars and crypt, as well as the tonsils themselves.) HPV is a common, sexually transmitted virus, which infects about 40 million Americans today. There are about 200 strains of HPV, the majority of which are thought to be harmless. Most Americans will have some version of HPV in their lifetimes, and even be exposed to the oncogenic / cancer causing versions of it. But only approximately 1% of those infected, have a lack of immune response to the HPV16 strain which is a primary causative agent in cervical cancer (with HPV18), cancers of the anus and penis, and now is a known cause of oral cancer as well. So we wish to be clear. Infection with even a high risk HPV virus does not mean that you will develop oral cancer. Most people’s immune systems will clear the infection before a malignancy has the opportunity to occur. It is likely that the changes in sexual behaviors of young adults over the last few decades, and which are continuing today, are increasing the spread of HPV, and the oncogenic versions of it. There are other minor risk factors which have been associated with oral cancers, but have not yet been definitively shown to participate in their development. These include lichen planus, an inflammatory disease of the oral soft tissues, and genetic predispositions. More about HPV and oral cancer