Vaccine may cut HPV infections, an oral cancer risk, in men
The HPV vaccine that helps prevent cervical cancer in women also might lower the risk in young men of oral infections that can cause mouth and throat cancers, a new study finds.
These cancers are rising fast, especially in men, and research suggests that HPV, the human papillomavirus, is spreading through oral sex. The actor Michael Douglas brought attention to this risk several years ago when he blamed his cancer on it.
This is the first study of whether the vaccine might prevent oral HPV infections in young men, and the results suggest it can. No men who had received at least one dose were later found to have infections of HPV strains linked to cancer, but more than 2 per cent of unvaccinated men had them.
“There may be additional benefits to vaccinating your son or daughter” besides the problems the vaccine already is known to prevent, said Dr. Maura Gillison of the University of Texas MD Anderson Cancer Center.
Results were released Wednesday by the American Society of Clinical Oncology. THE VIRUS HPV is very common — most sexually active people have been exposed to it. Some types cause genital warts. Usually, the virus causes no symptoms and goes away, but some people develop long-lasting infections of strains that can cause cancer.
The vaccine was approved in 2006 to prevent cervical cancers in women, and later, for some others including anal cancer in men. But acceptance has been slow — only about half of those eligible are getting it now, according to the latest information.
Now, awareness is growing of HPV’s other risks — oral infections are blamed for 70 per cent of cancers in the mouth and back of the throat. Rates are rising 5 per cent per year. They’re four times more common in men than women.
There are now more mouth and throat cancers caused by HPV in the U.S. each year than there are cervical cancers.
Oral sex is the main risk factor for getting an HPV infection in the mouth or throat, Gillison said. THE STUDY She led the study, funded by the National Cancer Institute, while previously at Ohio State University. Researchers interviewed 2,627 men and women ages 18 to 33 years in a national health study from 2011 to 2014 about whether they had been vaccinated, and tested oral rinse samples from them for HPV.
Infections with worrisome HPV strains were found in far fewer people who had received any shots — an 88 per cent lower risk. The results in men were striking — no infections in the vaccinated group versus 2.13 per cent of the others. The study was observational, so it can’t prove the vaccine was responsible. But it may no longer be ethical to do an experiment where one group gets no vaccine, because its benefits for preventing other cancers are known. It might be possible to do such a study in people over 26, the age limit now for HPV vaccination, Gillison said. If a benefit were shown, it might lead to expanding the group for whom the vaccine is recommended. WHAT PATIENTS SAY Tom Jackson had an HPV-related tonsil cancer, found in 2013, and works to fight stigma over an infection that is largely sexually spread. As a school board trustee in Houston, “I believe strongly that all children should receive all vaccinations,” Jackson said. “The horror of HPV cancer is tremendous,” and not to be “whitewashed” by squeamishness or reluctance to discuss prevention, he said. THE VACCINES The vaccines are recommended for young people, ideally before they’re exposed to HPV. Merck’s Gardasil is approved in the U.S. for females 9 through 26 to prevent cervical, vulvar, vaginal and anal cancers and genital warts. For males ages 9 through 26, it’s approved for preventing anal cancer and genital warts. A newer version of Gardasil that includes more HPV virus types is approved for males 9 through 15. GlaxoSmithKline’s Cervarix vaccine is approved for females 9 through 25 to prevent cervical cancer. All require two or three shots, depending on age. Other ways to help prevent oral HPV infections are limiting the number of sex partners and not smoking. Condoms or dental dams may help.
Signs and symptoms of mouth and throat cancers may include a long-lasting sore throat, earaches, hoarseness, enlarged lymph nodes and pain when swallowing.
Tom Jackson, 65, of Houston, shows where he first noticed a tumour related to his HPV-related tonsil cancer.