For the whole first half of his 20-year practice, oral surgeon Dr. Eric Carlson saw one basic type of male mouth cancer patient.
In file cabinet in his home office, he has thousands of slides: men in their 50s and 60s who were heavy smokers, heavy drinkers, hard livers. Many were war veterans; most all had "exposed himself to the classic carcinogens," Carlson said.
Then, in 2000, a man in his 30s in reasonably good health otherwise, who didn't drink or smoke excessively, came into Carlson's office. He had tongue cancer.
"Never saw that," Carlson said. "Never heard of it."
But that was about to change. Over the next 10 years, more and more relatively healthy men in their 30s, 40s and even 20s became patients of Carlson's because they had oral cancer. In fact, oral cancer cases have tripled over the past 20 years.
And the most common culprit, doctors eventually discovered, is no longer liquor, or smokes. It's HPV — human papilloma virus.
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