HPV-Related Cancers Increasing in Men

More men are being diagnosed with head and neck cancers. Could the HPV vaccine help?

When the vaccine for human papillomavirus (HPV) arrived in 2006, public health officials targeted the shot at teenage girls and billed it as a powerful tool for preventing cervical cancer. Today, many doctors and parents still view the sexually transmitted virus primarily as a threat to women. But as cases of HPV-fueled head and neck cancers soar among men, researchers now warn that men need to be thinking about HPV, too.

“By 2020, there will be more HPV-caused cancers among men in the United States than among women,” says Maura Gillison, MD, PhD, a cancer researcher with Ohio State University who was the first to recognize the link between HPV and oral cancer.

Doctors have long considered head and neck cancer diseases of older smokers. But in recent years, they have noticed an alarming surge of these cancers in nonsmoking men under 50.

Tests reveal a distinct cancer that — like cervical cancer — is kick-started by a certain form of HPV. Between 1984 and 2004, HPV-fueled throat, tonsil, and tongue cancers spiked 225%, with 80% of the cases in men. By 2020, each year 8,700 people will be diagnosed with the disease.

For most of those infected (84% of sexually active women and 91% of sexually active men will be infected at some point), HPV clears within a year with no symptoms. But guys appear to be uniquely vulnerable.
Men are three times more likely than women to have an oral HPV infection and five times more likely to carry the cancer-causing HPV. That’s partly because they tend to have more sex partners than women, and oral sex spreads oral HPV. But men also appear to be less adept at developing immunity to the virus, Gillison says.

So what’s a guy to do? First, he should vaccinate his son. “This is an anti-cancer vaccine, and we are not using it nearly enough,” says William Schaffner, MD, professor of preventive medicine at Vanderbilt University School of Medicine. In 2011, a federal committee recommended all boys get vaccinated by age 12, and as late as 26. Only 34.6% do so.

Should men older than 26 get vaccinated? “That is the big question now,” Gillison says. “People are starting to wonder whether the benefits of HPV vaccination could extend to men outside the recommended age range.”

No public health agency recommends it, insurance won’t cover it, and it’s expensive ($300-plus for a three-shot series). Nothing has shown for sure that it protects against head and neck cancer, Gillison says.

That said, it might make sense for some men to ask their doctor for the vaccine and pay out of pocket, Schaffner says. For a longtime monogamist newly entering the dating world, or a sexually active man eager to cover all his bases: “I see no harm in it.”

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