HPV and vaccination: Not just for girls anymore

Human papillomavirus (HPV) is the most commonly sexually transmitted infection. Certain types of the virus can lead to cancers affecting the vagina, cervix, throat, mouth, anus and penis. Penis? No, that wasn’t a typo. What many people don’t know is that men are also at risk for developing HPV.

Since the Federal Drug Administration approved the Gardasil vaccine in 2006, HPV awareness has gained considerable momentum. As an OB/GYN physician, I see young people becoming more educated on their health and seizing the opportunity to prevent the transmission of diseases and the development of cancers. But while there has been a tremendous growth in the number of vaccinations, Gardasil was originally marketed to young girls and very few adolescent males have taken part.

A recent study found that a mere 14 percent of males received the HPV vaccination compared with 44 percent of females, based on answers from parents of adolescents in the 2010 North Carolina Child Health Assessment and Monitoring Program. While HPV has been extensively studied in females, its prevalence among men remains largely overlooked. Findings of this study revealed that this was largely due to a lack of information given to parents by their child’s health-care provider. That’s a shocking finding and one that made me want to highlight the connection between HPV and cancer in men.

The Gardasil vaccine is now recommended for both girls and boys ages 11 to 12 and through age 26 if they did not receive the vaccine when they were younger. This age range is ideal because the levels of antibodies against HPV are higher than in older adolescents and adults. We are also trying to target young women and men before they become sexually active and are then possibly exposed to HPV. Gardasil is given in three doses over a specific time range between each dose. It is critical for the treatment of genital warts, can prevent the spread of infection, and decreases the chances of contracting cancerous types of HPV.

Cervical cancer is now the second most common and fifth most deadly cancer in women. Worldwide, in 2008, it was estimated that there were 473,000 cases of cervical cancer, and 253,500 deaths per year. Though not as publicized as cervical cancer, the male-related cancers caused by HPV are just as real. Men are equally likely to become infected with HPV as are women, but it is more difficult to identify the virus in males. The Centers for Disease Prevention and Control found that every year in the United States, 400 men develop cancer of the penis as a result of contracting HPV; 1,500 get HPV-related cancer of the anus, and 5,600 develop cancers of the oropharynx (back of the throat) that are connected with the virus.

The strains of HPV that cause warts are rarely the infections that become cancerous. However, the high-risk forms of HPV that are linked to cervical, anal, throat, neck and penile cancers often have no visible symptoms, so a majority of people will never know they have HPV. These high-risk types are spread primarily by genital contact, and in rare cases through oral-genital and hand-genital contact.

The human body can usually rid its system of the virus over time, but this clearance process can last up to two years, increasing the chance that the virus will be transmitted to other individuals.

Though understanding the medical risks associated with forgoing vaccination is a vital step in prevention, there are other implications that accompany the vaccine. I believe it is important to encourage Gardasil for young males not only because of the potential for guarding against HPV-related cancers, but also for the opportunity to educate them on safe sexual practices.

Historically, young girls and women have born the responsibility for safety in intercourse. They begin regular physician visits for pap tests at a crucial adolescent age, and they must take the initiative with birth control measures other than condoms.

Ensuring that boys and girls are made aware of the implications of becoming sexually active, particularly when it comes to sexually transmitted infections, is part in parcel of preventing the spread of HPV. Physician visits and their resulting education are central to spreading information and awareness about the vaccines. While abstinence is the only way to completely avoid the warts and potential cancerous cell developments related to HPV, understanding how to be responsible when it comes to sexual partners can significantly lower an individual’s risk of infection.

I would urge all parents and their adolescents to remain informed about vaccination and the role that sexual education can play in reducing the spread of HPV; this knowledge could ultimately be what safeguards children and young adults from its potentially life-threatening dangers.

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