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Experts said the figures show men are an 'important reservoi. r' for HPV, and should be included in control strategies. One in five men worldwide are infected with a potentially cancerous form of HPV, researchers have found. According to an analysis published in the Lancet Global Health journal, 21 per cent of men aged 15 and over are infected with at least one of the high-risk, potentially cancerous forms of HPV, or human papillomavirus – a family of more than 200 related viruses. In response to the findings, the World Health Organisation (WHO) said that more must be done to include men in global strategies to both reduce the risk for men and curb the spread of infection. While the majority of HPV cases are asymptomatic and resolve on their own, the virus can cause certain types of cancer, most commonly cervical – which kills around 340,000 women every year. But it is also linked to cancers of the genital areas and head, neck, throat and mouth – some of which affect men more than women and are becoming more common. In 2018, the International Agency for Research on Cancer estimated HPV was linked to more than 69,000 cancer cases in men. While HPV’s prevalence is fairly well-documented in women, estimates on its spread in men have been limited – until now.
HPV | The facts
It’s estimated that including boys in the HPV vaccination programme will prevent almost 50,000 non-cervical cancers by 2058, including 3,433 cases of penile cancer and 21,395 cases of head, neck and throat cancer in men. Vaccinated boys will also mean girls are doubly protected: “The girls’ programme has been very successful so far, and it’s already seen an impact in men as well as women,” says Dr Mary Ramsay, head of immunisation at Public Health England. “We’re hoping by adding boys to this it will accelerate the impact of the vaccination programme, bringing rates down even more quickly. I encourage all parents of eligible boys and girls to make sure they take up the offer for this potentially life-saving vaccine. It’s important not to delay vaccination, as the vaccine may be less effective as adolescents get older." When the jabs were first offered to girls in 2008, there was a catch up programme for older girls who had missed out, but this won’t be the case for boys. “Currently boys aged 13 to 18, who will have just missed out on the jab, won’t get a catch up programme like girls did in 2008, which is a decision Cancer Research UK is quite disappointed in,” says Sophia Lowes, health information manager at the charity. “However, parents can pay privately for their sons in that age group to have the vaccination. And it’s important to remember they have some protection, because most girls in that age group are vaccinated. After the age of 18 the vaccine is less effective, because you need it before you become sexually active and are exposed to HPV.”
After a systematic review which pooled data from more than 44,000 men across 65 previous studies, researchers estimated that one in three men globally are infected with genital HPV, while one in five had a “high risk”, potentially cancerous form. Infection rates overall were high among men aged 15-19 – suggesting they are being infected soon after their first sexual activity – but peaked among those aged 25-29. Rates remained high until the age of 50. This trend differs slightly from women, in which HPV rates decline with age, bar a slight spike during the menopause.
‘Important reservoir’
The new Lancet paper concluded that men are an “important reservoir of HPV genital infection”, and urged health authorities to consider targeting men with vaccinations, which are mainly used in women to prevent infection. Margaret Harris, a spokeswoman for the WHO, added: “The global study on HPV infection among men confirms how widespread HPV infection is in the sexually active population and affects not only women but also men. It also confirms the importance of introducing HPV vaccination in all countries and vaccines in the young population between 9 and 14 years of age before the HPV infection takes place.” The vaccine HPV is highly effective, having cut cervical cancer rates in England by 87 per cent since its nationwide rollout among teenage girls in 2008. In Britain, both girls and boys in year eight are routinely offered the vaccine, but across the world women have been prioritised in the rollout of inoculations. This is partly because there have been some shortages in supply. Ms Harris told the Telegraph that men are covered by “herd protection” when women are vaccinated, and said the latest study does not change the WHO’s advice to prioritise girls. But she added the paper reiterates that, where supply allows, men should be vaccinated and included in wider HPV control strategies. According to a 2022 WHO market analysis on the availability of HPV vaccines, there is now sufficient supply to inoculate two thirds of unvaccinated girls worldwide. “The market study also indicates that while in the short term adding secondary targets including older females and boys will have to be managed carefully, in the mid- and long term sufficient vaccines will be available for countries to add secondary targets such as boys if they can afford to do so,” Ms Harries added.
Cited research published in The Lancet Global Health (Sept. 2023):
https://doi.org/10.1016/S2214-109X(23)00305-4
