Boys Should Also Receive HPV Vaccines – A Story to Learn From

The human papillomavirus (HPV) vaccine protects against a virus that substantially increases various cancer risks, particularly cervical cancer among the diseases caused by this virusagainst which it protects. Around %5-6 of all cancers are thought to be HPV-related. Vaccination is widely thought necessary only for girls and young women, but vaccinating boys is at least equally important.

The Story of Phil Rech With HPV-Related Head and Neck Cancer

Phil Rech was diagnosed with tonsil cancer in 2014 at age 59. Cancer surgery removed his tumor, followed by adjuvant (protective) radiotherapy.

Phil did not smoke, rarely drank and was not overweight. He generally had no unhealthy habits. At diagnosis, he did not question the cause because he focused completely on recovery.

Like many people in the UK and worldwide, he was unaware of HPV as a cancer-related threat.

• The Link Between Head and Neck Cancers and HPV

He was very surprised when tumor testing revealed his cancer was HPV-related. He had not known HPV could cause such a serious health problem.

In 2017, three years later, Phil's cancer recurred and had spread to his brain and lungs. A study in 2017 found oral HPV in every 9 American men, one of them. Researchers estimated nationwide US oral HPV in %11.5 of men and % 3.2 of women, affecting 11 million men and 3.2 million women.

Phil said; "If the vaccine had existed when I was younger and I had known about it, I would certainly have had it. I will call for all children to be vaccinated. Children receive vaccines for polio, measles and mumps, but HPV should be included because it is just as serious and life-threatening as any of these." as his statement.

HPV Infection and Cancer

HPV has more than 150 subtypes. Around 40 cause human infections, and some carry high cancer risk (highest-risk HPV 16 and 18). Lower-risk types generally cause genital or oral warts.

HPV is very common. Of every 10 people, 8 are estimated to become infected during life. The body generally clears infection without problems (around %90 resolve within two years). Sometimes persistent infections increase cancer risk because the virus inserts its DNA into the infected cell's DNA, and viral products cause genetic damage and uncontrolled proliferation, or cancer. The figure below illustrates progression from HPV infection to cervical cancer.

Why Should Boys Also Receive HPV Vaccines?

The most widely available vaccine protects against 4 HPV types (4-valent). Two are associated with cancer (16 and 18), and two mainly with genital warts (6 and 11). It was initially recommended only for girls because the strongest benefit and cost-effectiveness evidence concerned cervical cancer and genital warts.

Boys should also be vaccinated because HPV increases not only some cancer risks in women but head and neck, anal and penile cancer risks in men.

Vaccinating men at the right time also protects their female partners. Men who have sex with men can also be vaccinated up to age 45; vaccination during adolescence provides better protection, while remaining unvaccinated increases anal and oral cancer risks.

Ongoing HPV disease research concludes that vaccination prevents infection and reduces future risk of at least 7 cancer types, particularly cervical and head and neck cancers.

Almost everyone is believed to need vaccination before becoming sexually active and before HPV exposure. In the UK, girls aged 12 to 13 began vaccination in 2010; follow-up found HPV 16 and 18 infections reduced by % 86.

Vaccinating girls alone is insufficient because boys also face genital warts and anal, penile and head and neck cancers.

• The Story Behind HPV Vaccine Discovery

When Should HPV Vaccination Be Given?

• Vaccination is recommended for girls and women aged 9-26 and boys and men aged 9-21.
• Age matters for vaccine immunity. The ideal vaccination age for both sexes is recommended as 11-12.