HPV vaccine for boys may prevent cancer and save money
Vaccinating boys against the human
papillomavirus (HPV) might be cost effective over their lifetimes to
prevent a type of throat and mouth cancer, new Canadian modelling suggests.
The HPV vaccine is covered for girls to prevent cervical
cancer. The vaccine also reduces anal cancer in both genders as well as
some cancers of the penis and oropharyngeal cancer, which starts at the back of
the throat and mouth, and involves the tonsils and base of the tongue.
Dr. Lillian Siu, a senior medical oncologist at the
Princess Margaret Cancer Centre in Toronto, has treated oropharyngeal cancer
for about 18 years and has seen the incidence rise.
"We would see now about 80 per cent of our oropharyngeal cancer patients are what we call HPV positive," said Siu. "It is a morbid disease so I think we have to spend some time thinking about how to prevent it."
To that end, Siu and her team created a model to compare
the potential cost savings of vaccinating a theoretical group of about 190,000
boys at age 12 followed over their lifetime using factors such as vaccine cost,
vaccine effectiveness, costs of cancer treatment and how the quality of life of
cancer patients diminishes.
"We don't know how to predict who will get the disease and anyone who is sexually active is at risk of developing such a cancer," Siu said.
In Monday's online issue of the journal Cancer, Liu and
her coauthors concluded the vaccine could potentially save between $8 million
and $28 million over the boys' lifetimes, or up to nearly $42 per person per
year, compared with no vaccine.
Confrontation with mortality
Siu isn't advocating for the vaccine to be offered free
to boys until more research is done. "I think if we can raise the
awareness to start looking at this question in greater depth, we've achieved
our goal."
One limitation of the model is the researchers weren't
able to account for the interaction with smoking, another risk factor for
oropharyngeal cancer. In developed countries, HPV is surpassing smoking as a
cause factor, she said.
Conservative MP Peter
Kent became an advocate for HPV vaccination after his diagnosis in
2013.
"It was my first confrontation with mortality and I thought, well, here we go," Kent recalled. "The diagnosis was Stage 4 HPV-related cancer, which is a fairly ominous diagnosis."
Kent had seven weeks of radiation treatment and three
rounds of chemotherapy.
"I don't want any youngster today to face what I did, to experience what I did, 10 or 20 or 30 or 40 years down the road because it is avoidable and I think that governments have to face their responsibility and make that investment in the future."
Three doses of the vaccine cost about $500. B.C. and
Quebec use two doses for
girls. Currently, Alberta and Prince
Edward Island cover the cost for boys. Nova Scotia's new budget
includes plans to add HPV vaccines for boys in Grade 7 in the
fall.
Toronto pediatrician Dr. Marvin Gans tells families about
the costs and benefits of HPV vaccination for both girls and boys.
Some studies point to benefits for men by vaccinating women through herd immunity. "Clearly, the more girls that get [vaccinated] the decrease we'll see in males. However, that's not a guarantee of how to do things."
At Gans' office, Fern Stark sees the preventive value.
"I think boys, teenaged boys, should have the vaccine. In fact my older
son who is almost 17, has had it and I'm going to be making arrangements
for my younger son, who is 13, to get it."
Source - cbc.ca
