Jabs for the boys: Why young males need to get the HPV vaccine

There is every reason to give the HPV vaccine to boys, who are just as vulnerable as girls to the fall out of the virus, writes Dr Phil Kieran.

I was recently asked do I think that boys should be vaccinated for HPV? It is a question that I get asked in my surgery about once every three to six months and it’s a great opportunity to discuss the effects of HPV on males, a topic that is not discussed widely.

Human papilloma virus or HPV is the virus which causes warts. The most common form of these are the warts most of us have had on our hands or the verruca, which left you hobbling around for the summer during your childhood.

For a very long time, the medical community thought that warts were the only consequence of this virus. However, in 1983 HPV DNA was found in some cervical cancers. We now know that pretty much all cervical cancers are caused by HPV and, what’s more, they are implicated in a lot of other cancers as well.

While cervical cancer doesn’t affect men, other cancers do. HPV causes up to a quarter of all oral cancers and is the main cause of a number of penile and anal cancers. HPV is one of the most common sexually transmitted infections. So much so that 80% of adults have been exposed to it as some time in their lives. For most, this virus is cleared from their system over the course of two to five years and causes no symptoms, or — at worst — transient, easily treated warts on the skin.

Warts, genital or otherwise, are not life-threatening but do cause a huge amount of distress to people. You can easily see this through to multiplicity of options available for treating warts. However, for a small number of people the virus doesn’t clear fully and in fact can transfer some of its own DNA into the DNA of the cells around it.

This can start a chain of events leading to pre-cancerous changes and on to cancer.

This is what happens with cervical cancer and the exact same changes can occur in the delicate skin of the mouth, penis, or anus, causing the same type of cancers to form.

HPV is believed to cause about 25% of all cancers in the mouth and throat

What can you do to prevent this? Unfortunately if you are sexually active you have probably already been exposed to this virus. (Most likely it has been cleared by your immune system). You are still at risk of getting re-infected with either the same strain or a different strain throughout your life, so safe sex using condoms and or dental dams is the best way of reducing your risk.

Protecting yourself from re-infection is the most important health step to take and thankfully it is very unlikely you will develop cancer even if the infection doesn’t clear fully. But it is a risk factor and the real problem comes when further risks are added. For example, smoking is implicated in most of these cancers also so it seems to trigger the above changes.

These are risks you can change. If you smoke please stop now. If you have poor dental health go and see your dentist as the irritation of rough dental surfaces increases the risk of oral cancer. Don’t drink too much alcohol — spirits are worse than beer or wine for contributing to oral cancer as the high concentration of alcohol is more irritating to the skin. Most importantly, if you notice any lumps or persistent sore areas in your mouth or genitals, don’t ignore them. Get them checked.

The Department of Health, via the Health Information and Quality Authority, is conducting a study to see whether it is cost-effective to follow the lead of countries like Australia, Canada, and the US and start routinely vaccinating boys in this country the same way we do girls. This is a development I would warmly welcome to reduce the risk of cancer for men in this country as well as women.

In the event there is not a national programme for boys, I will buy this vaccine for my sons when they reach 12 or 13 years of age.

The big problem is the expense. With the vaccine costing in the region of €200 per shot, you are looking at somewhere in the region of €400-€600 to complete the course.

Some health insurers are being more proactive about this but hopefully this will only be needed in the very short term (depending on the findings by HIQA as to whether the vaccine will be funded for boys).

For those who have doubts, it’s worth pointing out that the vaccine is safe and has been shown to work across many international studies.

Most importantly, I encourage you to practise safe sex as HPV is the most common STI there is and using protection could very well save your life.