‘It’s an equity issue, we are currently denying a life saving vaccine to half of our young people, and keeping them in the dark about how the HPV vaccine could protect them from cancers, just as it does for our young women,’ Professor Pitts says.
‘Most people now know that HPV is a major cause of cervical cancer, but few realise that the virus can affect other sites, including the ano-genital tract and cancers of the head and neck.’
‘There has been a rapid increase world-wide in the incidence of cancers in the head and neck, most especially oropharyngeal—tonsils and tongue—cancers,’ she says.
In November 2006, the Australian Government announced funding for a HPV vaccination program. The National HPV Vaccination Program provides the vaccine for all young women through school programs at age 12-13 years while the national catch-up program vaccinated women up to 26 years of age.
Australia is internationally acclaimed for the success of these vaccination programs, which have achieved a widespread coverage only dreamt of in other countries in Europe and North America.
‘Ironically, however, it is this very success that means that young Australian men do not benefit from a funded school based vaccination program,’ says Professor Pitts.
‘The models of HPV vaccination show that including young men in the vaccination program is only rated as cost effective and beneficial if coverage among young women is below 50 per cent.’
‘Given our outstanding success in vaccinating over 80 per cent of eligible young women, we are denying the benefits of this vaccine to our young men,’ she says.
There is striking evidence that rates of oropharyngeal cancers are rapidly rising in many parts of the world. In Australia, the proportion of oropharyngeal cancers that were HPV related increased from 19 per cent at the end of the 1980s to 66 per cent by 2006.
Worryingly oropharyngeal cancers have a high mortality rate, about half die within five years of diagnosis.
‘Our national studies have shown that while young people’s knowledge of HPV and cervical cancer is generally poor, there has been an educative element to vaccination, with those reporting HPV vaccination demonstrating better knowledge.’
‘Furthermore our studies confirm that, compared with women, men of all ages know far less about HPV and the benefits of an HPV vaccination for them,’ says Professor Pitts.
Certain groups are at even higher risk of HPV related cancers. Gay men have a greatly increased risk of anal cancers—most of which are caused by HPV—compared with their heterosexual counterparts.
A recent study published in the New England Journal of Medicine found that gay men who were vaccinated against HPV developed 75 per cent fewer anal lesions that lead to cancer than their counterparts who were given a placebo.
‘People with a compromised immune system, such as those who are HIV positive, men or women, have a well established increased risk of HPV related cancers of all types,’ says Professor Pitts. Meghan Lodwick
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