On World Cancer Day 2014 (4 February), HPV Action is launching a campaign calling for the government to act immediately to end the serious future health risks facing boys from a wide range of cancers. 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. In men, it can cause anal, penile, head and neck cancers, as well as genital warts.
HPV Action is a new coalition of 25 patient and professional organisations. We believe that boys as well as girls should be given the HPV vaccine in order to prevent males from being exposed to the unnecessary risk of developing HPV-related diseases.
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, conducted for HPV Action, asked whether boys should be offered the same free HPV vaccine as girls. A resounding two-thirds (64%) of the 1,336 UK parents polled were in agreement, with only 11% disagreeing and 25% not knowing (1). 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 (assuming a 90% vaccination rate) (2).
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. In addition, it accounts for 40,392 new cases of genital warts found in men in 2012, a 15% increase since 2003.
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 to extend the vaccination programme to boys. Many MPs are already backing the call for change. Sir Paul Beresford, MP for Mole Valley, raised the issue in Parliament on 13 January 2014 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.” Furthermore, 59 MPs last year signed an Early Day Motion seeking gender-neutral vaccination.
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 eradicate successfully 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 at Real Madrid, 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 head, neck, penile or anal cancer. Smear tests, for example, are available for women to detect cervical cancer, but men only know they have a HPV-related disease when symptoms appear.
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 (3); the economic burden of HPV-related cancers in France is about £198 million (4). The cost of treating genital warts was almost £17 million in England in 2008 (5). 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) (6).
The cost-effectiveness of vaccinating boys has been 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.
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.
For media enquiries about HPV Action’s launch, contact:
Sarah Street email@example.com 0203 643 1709 / 07973 316 818
Gabby Brunton firstname.lastname@example.org 07538 877 685
(1) All figures, unless otherwise stated, are from YouGov plc. Total sample size was 2,289 adults (1,336 parents). Fieldwork was undertaken on 22-24 January 2014. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).
(2) Based on Throat Cancer Foundation data for Scotland, extrapolated for the UK as a whole, presented to the Scottish Public Petitions Committee.
(3) 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.
(4) Borget I, Abramowitz L, Mathevet P. Economic burden of HPV-related cancers in France. Vaccine 2011; 29:5245-5249.
(5) 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
(6) 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.