Why a women-only approach falls short – Firstpost

Conversations about the human papillomavirus or HPV, have become increasingly common in the past few years. However, the discussion is often times limited to cervical cancer, with recommendations focused on vaccinating girls and women against HPV as prevention. HPV however, can also cause cancer in men and there is a lack of dialogue and knowledge regarding the benefit of vaccinating boys and men. HPV-related infections can lead to penile, anal, or oropharyngeal cancer in men. Hence, it is equally important to vaccinate men against HPV.

HPV and men

There are over 200 different strains or types of HPV. Of them, 40 strains can infect the genital area including the skin of the vulva, vagina, cervix, penis, scrotum and anus. It is one of the most common sexually transmitted infections (STIs) and is spread through skin-to-skin contact. Those who are sexually active yet unvaccinated may contract HPV even without knowing it. In most cases, the immune system can get rid of the infection within a year.

Approximately 15 strains are consider high risk due to their association and propensity to cause cancer. In women, these strains infect a type of cell in the cervix, called squamous cells, which can lead to changes resulting in cervical cancer. In men, HPV infections are responsible for almost 50 per cent of all cases of penile cancer, 10 per cent of cancers of the larynx, between 33 per cent and 72 per cent of cases of oropharyngeal cancer, and 85 per cent of cases of anal cancer. The incidence of HPV-related cancers have been increasing among men over the past few decades and vaccination may help to curb the rise in cases. Sexual behaviour, such as having more lifetime partners and engaging in men who have sex with men (MSM) practices, is linked to an increased risk of HPV.

Importance of HPV vaccine for males

While there has been a significant push towards vaccinating women against HPV, the same urgency is absent when it comes to men. As per global figures, about 4 per cent of men receive the vaccine. There are several reasons why men must receive it. The immune response in men to HPV is generally poor and does not provide adequate protection, resulting in high prevalence, frequent reinfections and high rates of transmission. Men are disproportionately affected by HPV related oropharyngeal cancers by a 2 to 1 ratio. Moreover, it can affect sperm health and quality leading to difficulty with fertility.

Several barriers to enhancing vaccine uptake exist. The most common is the lack of awareness or reluctance to be vaccinated due to embarrassment, fear of side effects and perceived low susceptibility to the virus. Furthermore, there is a significant amount of misinformation, especially the notion that HPV affects only females. Also, cultural or community-based norms impact uptake.

Hence, it is necessary to formulate strategies that prioritize vaccinating men and women against the HPV virus. Vaccination can prevent 90% of the HPV-related cancers. Ideally, the process must begin in children between 11 and 12 years of age prior to HPV exposure. Furthermore, early vaccination can potentially provide herd immunity which may reduce the rate of infection at a larger scale. Stakeholders must enhance efforts to create awareness about the virus and prevention strategies to improve vaccine acceptance.

According to the WHO, HPV vaccination is one of the most effective ways to reduce the global cancer burden. While several countries have made vaccinating girls and women mandatory, it is necessary to adopt the same approach towards boys and men. Dispelling myths, providing education, and encouraging individuals can enhance vaccine uptake among men and boys. Vaccination against HPV is not just an individual decision but a collective responsibility of the community.

The author is MD, Head and Neck Medical Oncologist, Memorial Sloan Kettering Cancer Center, New York, US. Views expressed in the above piece are personal and solely those of the author. They do not necessarily reflect Firstpost’s views.