HPV vaccine access must be expanded

As the adage goes, an ounce of prevention is worth a pound of cure. In the fight against HPV, however, we don’t have the balance quite right.

Rates of some cancers caused by the virus have increased, particularly among men. This trend won’t reverse for years, highlighting why health officials must ambitiously tackle the problem now.

Almost every sexually active person will get the human papillomavirus (HPV) at some point, making it the most common sexually transmitted infection, though most varieties clear within a year or two. But between 1997 and 2012, there was an alarming increase in the incidence of mouth and throat cancers caused by HPV: a 56 per cent spike for men and a 17 per cent pop for women, according to a new Canadian Cancer Society report.

It’s not clear exactly what caused this spike and gender discrepancy; it could be anything from changes in sexual practices to immune system differences between men and women. But considering how long it takes for HPV to cause cancer, many of these people likely contracted the virus back in the 1960s and ’70s.

A vaccine was first approved in Canada for females aged nine to 26 in 2006; six years later, it was approved for males in the same age range. Rates of vaccination against HPV range nationwide from 47 per cent in the Northwest Territories to 93 per cent in Newfoundland and Labrador. In Ontario, the coverage for females (it’s too soon to tabulate for males) has reached 80.2 per cent.

Provinces started rolling out vaccination programs in 2007, according to the Canadian Cancer Society. By 2010, all provinces and territories had them for girls, but not all did — or yet have — for boys. In Ontario, the vaccine is offered to all Grade 7 students — boys as of this year, girls since 2007.

There are discrepancies between what provinces offer, and what they offer each gender. This should change. While there is a degree of herd immunity given high vaccination rates among women and girls, plenty of men don’t have sex with women. And the age of vaccination matters — ideally it should happen before someone becomes sexually active.

Getting HPV isn’t just contracting an STI; it increases cancer risk. Provinces should move quickly to better educate families and make vaccinations more widely available. The battle against many cancers has benefitted from major public relations campaigns, but this is just starting on HPV.

A concerted effort now should show, over the next few decades, important health improvements.