Immunisation used against cervical cancer in girls can also prevent diseases in young men
The Government could save thousands of lives and hundreds of millions of pounds for the NHS by vaccinating boys against a cancer-causing virus at a cost of around £20m a year, a coalition of health experts and campaigners says.
HPV Action, which has attracted the high-profile backing of leading charities and a medical royal college, wants the national vaccination programme against the human papilloma virus (HPV), currently only available to girls aged 12 to 13, to be extended to boys, amid growing evidence of the virus’s role in causing cancers of the mouth and throat.
Girls have been given the vaccine since 2008 to protect them against cervical cancer, which is known to be caused by HPV infection in most cases. But it is now well established that the sexually transmitted virus is also responsible for a significant proportion of cancers in other parts of the body, including the throat, anus and penis. Many scientists suspect it may be the root cause of rising rates of oral and throat cancers in both women and men.
The campaign group will this week present new evidence from Denmark which counters the UK Government’s assessment that vaccinating boys is unnecessary – and will argue that the human rights of British boys are being infringed by denying them the vaccine.
Government experts last month began an investigation into the cost-effectiveness of extending the vaccine to boys, or men who have sex with men, or both. The Joint Committee on Vaccination and Immunisation (JCVI) established a subcommittee for the purpose in October last year, which held its first meeting at the end of January.
Jamie Rae, founder of the Throat Cancer Foundation, one of 25 groups which back HPV Action, said there was no financial argument against extending the vaccine to all boys. HPV Action cites figures from Nordic countries suggesting that an individual can be immunised for just £45. The group estimates it would cost only £24m a year to reach and vaccinate 367,000 12-year-old boys – about 0.02 per cent of the NHS annual budget.
“It’s not going to break the bank,” Mr Rae told The Independent on Sunday. “The premise that vaccinating girls will protect boys doesn’t stack up. It’s inequitable – in fact, I’d say it’s an infringement of human rights, for all boys.”
HPV Action has won the backing of 25 leading health organisations, including the Royal College of Obstetricians and Gynaecologists, the British Dental Association, the Royal Society for Public Health and the Terrence Higgins Trust. Their campaign will gather pace this week, and a national petition is planned which will be presented to the Health Secretary, Jeremy Hunt, later this year.
HPV is a common virus which most sexually active people will contract at some point. In the vast majority of cases it goes away without causing any harm, but if the virus persists it can cause changes in cells, which can develop into cancer.
It is usually transmitted through sexual contact and is also the cause of genital warts. Vaccinating women does protect men by reducing the extent to which the virus can circulate, but campaigners have long argued that the policy discriminates against men who have sex with men, and men could still contract the virus from sexual contact with an unvaccinated woman. The vaccine is most effective if given before a person becomes sexually active.
A sharp rise in oral cancers in recent years has been attributed to a strain of HPV that can spread via oral sex, and the actor Michael Douglas made headlines last year when he attributed his throat cancer to HPV contracted in that way. Cases of oral cancers – including cancers of the throat – have increased from 4,400 per year in 2002 to 6,200 in 2012, with two thirds of cases in men.
HPV Action said that global evidence pointed to the virus being the causal agent of 5 per cent of all human cancers. Among men, it has been linked to 90 per cent of anal cancers, 60 per cent of penile cancers and 75 per cent of tonsillar and base-of-tongue cancers, as well as 40,400 new cases of genital warts in 2012.
New evidence from Denmark suggests that, despite vaccinating women against HPV, rates of genital warts in men have not declined, indicating that protecting women may not be as effective at protecting men from HPV as previously thought.
The campaign group said that the cost of treating HPV-related cancers runs into the hundreds of millions, with the likely decline in incidence if boys were vaccinated equating to large savings for the NHS. In Italy, a study suggested that the treatment of nine HPV-related diseases cost £437m, while in France the economic burden of such cancers is £198m.
Tristan Almada, a leading figure in HPV Action, and founder of the HPV and Anal Cancer Foundation, a charity he set up with his sisters after they lost their mother to HPV-related anal cancer, said the Government had a chance to “eradicate” HPV.
“The public consciousness has associated the virus with being female-only. That’s a barrier,” he said. “Ten years ago, when the Government and pharmaceutical companies were designing the safety studies, they were using an evidence base that has been significantly updated. Every study I have seen is saying HPV is linked with more cancers every year. Yet we have this amazing prevention tool that can eliminate this risk.”
A Department of Health spokesperson said: “More than 80 per cent of girls are now vaccinated against HPV. However, we recognise that the current vaccination programme does not offer protection against HPV-related cancers for gay men, which is why the JCVI has set up a sub-committee to assess whether the programme should be extended to adolescent boys, men who have sex with men, or both.”
‘By the end you have dropped several stone, you can’t eat, you can’t speak…’
Jamie Rae, 49, is an entrepreneur and founder of the Throat Cancer Foundation. He also helped set up HPV Action. He was diagnosed with HPV-related oropharyngeal cancer in May 2010
“I was living in Hong Kong at the time, but travelling regularly back to Scotland. One day mid-flight, I went to the toilet and noticed under the lighting a small lump on the right side of my neck that I hadn’t seen before, the circumference of a 10p piece. Back in Scotland, I saw a specialist who asked if I was a smoker or a heavy drinker. I said no. Then he asked: “Have you heard of HPV?” He told me that 10 years ago, most of his patients were drinkers and smokers in their sixties. Today, more than 60 per cent are in their forties, don’t smoke, and the cancer is caused by HPV. And that’s what I had.
“I went into the conveyor belt of treatment. It started with tonsillectomy, followed by chemotherapy and radiotherapy. By the end you have dropped several stone in weight, you can’t eat, you can’t speak, you’re just hanging on: a horrible place to be. I was told I was cancer-free on 10 December 2010.
“I went through a horrific time getting treated for throat cancer – if there’s a simple jab that can prevent it in boys growing up today, then, my God, I hope we can use it.”
* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
** OCF is one of the founding members of this group. With our friends at the HPV and anal cancer foundation, we are the two organizations are the primary funders of their public outreach.