Men's Health Articles

The government should act immediately to end the serious future health risks facing boys from some of the UK’s fastest growing cancers, says HPV Action. HPV is commonly known to be the primary cause of cervical cancer in women, but it is also a real and rapidly growing health threat to UK men.

HPV Action, a new coalition of 25 patient and professional organisations[i] including the HPV and Anal Cancer Foundation, Oral Cancer Foundation, British Dental Health Foundation and Throat Cancer Foundation, believes boys as well as girls should be given the HPV vaccine (commonly known as the cervical cancer jab), in order to prevent males from being exposed to unnecessary risks of developing HPV-related cancers and genital warts.

Today, 4 February 2014, is World Cancer Action Day. The USA, Australia, and some Canadian provinces now offer the HPV vaccine to boys – but the UK restricts access to the cancer-preventing vaccine to girls. A recent YouGov poll asked whether boys should be offered the same free HPV vaccine as girls. A resounding 64% of the 1,336 UK parents polled were in agreement, with only 11% disagreeing and 25% not knowing.[ii] HPV Action estimates that extending the vaccine to 367,000 currently unprotected 12-year old boys will cost the UK government just £24 million a year.[iii]

HPV is the causal agent in 5% of all human cancers. Among cancers affecting men, it is estimated that HPV infection is associated with up to 90% of anal cancers, 60% of penile cancers, and 75% of tonsillar and base-of-tongue cancers with each of these cancers having increased in incidence over the past two decades.[iv] In addition, it accounts for 40,392 new cases of genital warts found in men in 2012, a 15% increase since 2003.[v]

As well as calling on the government to act, HPV Action is urging members of the public to write to their MPs and sign a new online petition calling for Health Secretary Jeremy Hunt MP[vi] to act on the issue. Many MPs are already backing the call for change; Sir Paul Beresford, MP for Mole Valley, on the 13th January 2014 raised the issue in Parliament and said that “The number of annual cases of HPV-causing cancers in men is rising significantly…The burden of HPV-associated cancers is now almost the same on men as it is on women… It is not fair, ethical or socially responsible to have a public health policy that leaves 50% of the population vulnerable to infection”[vii] Furthermore last year, 59 MPs signed an Early Day Motion seeking gender-neutral vaccination.[viii]

Tristan Almada, who co-founded The HPV and Anal Cancer Foundation after losing his mother to HPV-related anal cancer in 2010 said: “I want to prevent the horror my family went through from ever happening to anyone else again. We have that opportunity today via universal HPV vaccination. The UK should be a leader, not a laggard, to the rest of the world – being the first country to proudly say it has successfully eliminated the causal agent of 5% of all cancer by extending the well-implemented female-only programme to boys. The world has used vaccines to successfully eradicate many infectious diseases including smallpox and polio – it is time we act urgently to add HPV and the devastation it causes to the list.”

Peter Baker, HPV Action’s Campaign Director said: “For a cost equivalent to footballer Cristiano Ronaldo’s salary, about £24 million a year, we can protect 367,000 boys a year against the future risk of a range of cancers as well as the very common problem of genital warts. Vaccinating girls alone is not enough to tackle HPV: men can still get the virus HPV from unvaccinated women from the UK and other countries or from other men. It is simply unfair to deny boys in the UK the same level of protection as girls or as boys in Australia and other countries where both sexes are now routinely vaccinated. HPV vaccination is one of the easiest ways of preventing cancer.”

The current programme of vaccinating girls only is based on the premise of protecting them from cervical cancer, of which there are approximately 3,000 cases a year. But the policy fails to consider the thousands of cases of HPV-related cancers in other sites, which tend to predominate in men.

The vaccine is extremely important in men because there are no effective, widely used screening tools to detect the early stages of HPV-related oral, penile or anal cancer. Smear tests, for example, are available for women to detect cervical cancer, but men only know they have HPV when a related disease develops cancer – often in difficult to treat later stages.

HPV Action argues that introducing a vaccination programme for both sexes would also save money in the long run. The costs of treating nine major HPV-related diseases in Italy are an estimated £437 million a year[ix]; the economic burden of HPV-related cancers in France is about £198 million.[x] The cost of treating genital warts was almost £17 million in England in 2008.[xi] The cost of treating RRP (recurrent respiratory papillomatosis) has been estimated at £4 million a year in the UK (about 600 boys and men in the UK live with this rare but very unpleasant breathing disorder caused by HPV).[xii]

Cancer is a terrifying prospect but the cancers caused by HPV are easily preventable through vaccination. By not protecting boys, and the men they become, we are unfairly leaving the burden of eliminating a virus that affects both sexes to women. A gender-neutral virus requires a gender-neutral vaccination programme.

Sign the petition: http://chn.ge/LSUVHo

www.hpvaction.org @HPVAction

Myths

• It’s a myth that HPV only affects women so only women should be vaccinated. Men and women are both at risk from HPV related cancers.
  
• It’s a myth that men will only have sexual contact with vaccinated women and therefore not exposed to the risk of HPV infection The UK population is highly mobile and many men will therefore have sexual contact with UK women who are not vaccinated, women from other countries who have not been vaccinated, or other men who are not vaccinated.
  
• It’s a myth HPV only affects those who are sexually promiscuous even though it is a sexually transmitted infection. 80% of the population is infected with HPV at some stage in their lives.
  
• It’s a myth that only men who have sex with men get anal cancer or HPV-related cancer.
  

Truths

• Most people will contract HPV in their lifetime and clear the virus. But for some people, HPV becomes a cause of cancer—such as cervical, anal, penile, vulval, head, neck and throat cancer – and genital warts.
  Cancer sites where at least a proportion is attributable to HPV:
• Oral cancer 6767 cases cases/year, 2056 deaths/year[xiii]
  
• Cervical cancer 3064 cases/year, 972 deaths/year
  
• Laryngeal (larynx) cancer 2360 cases/year, 798 deaths/year
  
• Anal cancer 1175 cases/year, 299 deaths/year
  
• Vaginal Cancer, 256 cases/year, 91 deaths/year
  
• Vulval cancer 1203 cases/year, 404 deaths/year
  
• Penile cancer 558 cases/year, 111 deaths/year
• In 2012, there were 40,392 new cases of genital warts in men.[xiv]
  
• HPV Action estimates it would cost £24million/year to vaccinate UK boys (assuming a 90% vaccination rate).
  
• There are no UK figures, but a study of the cost of treating nine major HPV-related diseases in Italy produced an estimate of almost £440 million a year.[xv]
  
• A similar study of the economic burden of HPV-related cancers in France estimated to be about £199million.[xvi]
  
• The estimated costs of HPV-related anal cancer treatment, rehabilitation and sick leave in Germany have been estimated at £24 million annually.[xvii]
  
• The cost of treating genital warts was almost £17million in England in 2008.[xviii]
  
• The cost-effectiveness of vaccinating boys has confirmed by the Pharmaceutical Benefits Advisory Committee in Australia, the independent, expert body responsible for undertaking objective assessments of the clinical effectiveness and cost-effectiveness of vaccines before they are added to the country’s national immunisation programme.

[ii]All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,289 adults (1,336 parents). Fieldwork was undertaken between 22nd - 24th January 2014. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).
[iii]http://www.scottish.parliament.uk/gettinginvolved/petitions/PE01400-PE01499/PE01477_BackgroundInfo.aspx
[iv] National Advisory Committee on Immunization (NACI). Update on Human Papillomavirus (HPV) Vaccines. Canada Communicable Disease Report; January 2012(38); ACS-1 . D’Souza G, Dempsey A. The role of HPV in head and neck cancer and review of the HPV vaccine. Preventive Medicine 2011; 53: S5-S11.
[v] Public Health England data. www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1215589015024
[vi] http://www.change.org/petitions/jeremy-hunt-uk-health-secretary-introduce-hpv-vaccination-for-boys-to-stop-many-preventable-cancers-3
[vii] www.publications.parliament.uk/pa/cm201314/cmhansrd/cm140113/debtext/140113-0004.htm
[viii] http://www.parliament.uk/edm/2012-13/980
[ix] Baio G, Capone A, Marcellusi A, et al. Economic Burden of Human Papillomavirus-Related Diseases in Italy. PLoS ONE 2012; 7(11):e49699 doi:10.1371/journal.pone.0049699.
[x] Borget I, Abramowitz L, Mathevet P. Economic burden of HPV-related cancers in France. Vaccine 2011; 29:5245-5249.
[xi] Desai S, Wetten S, Woodhall SC, et al. Genital warts and cost of care in England. Sexually Transmitted Infections 2011 doi:10.1136/sti,2010.048421
[xii] Donne A.J., Clarke R. Recurrent respiratory papillomatosis: an uncommon but potentially devastating effect of human papillomavirus in children. International Journal of STD and AIDS 2010; 21:381-385.
[xiii]http://www.cancerresearchuk.org/cancer-info/cancerstats/types/oral/incidence/

[xiv] Public Health England data. www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1215589015024
[xv] Baio G, Capone A, Marcellusi A, et al. Economic Burden of Human Papillomavirus-Related Diseases in Italy. PLoS ONE 2012; 7(11):e49699 doi:10.1371/journal.pone.0049699.
[xvi] Borget I, Abramowitz L, Mathevet P. Economic burden of HPV-related cancers in France. Vaccine 2011; 29:5245-5249.
[xvii] Heitland W, Shädlich PK, Chen X, et al. Annual cost of hospitalization, inpatient rehabilitation and sick leave of anal cancer in Germany. Journal of Medical Economics 2012; 1-8.
[xviii] Desai S, Wetten S, Woodhall SC, et al. Genital warts and cost of care in England. Sexually Transmitted Infections 2011 doi:10.1136/sti,2010.048421