• 8/1/2006
  • Washingtn, D.C.
  • staff
  • United Press Interenational (www.upi.com)

The new vaccine that can prevent about 75 percent of cervical cancer should be given to men, boys and even women already exposed to the virus that causes the disease, researchers said Monday.

Although the human papillomavirus (HPV) has been approved for women aged 9 to 26, Bradley Monk, in a commentary to be published in the August issue of the journal Obstetrics and Gynecology, argued that more widespread use of the vaccine may improve the chances that most of cervical cancer can be banished.

“We need to work together to implement this huge breakthrough by widespread vaccination of young people, both genders without regard to risk,” Monk, assistant professor of obstetrics and gynecology at the University of California-Irvine, told United Press International.

HPV, a sexually transmitted disease, is ubiquitous in the United States, with about 20 million men and women currently infected, according to the Centers for Disease Control and Prevention.

Moreover, the agency says that about 80 percent of U.S. women by age 50 will be exposed to one of the 100 strains of HPV, known to cause genital warts and cervical, vulva and vaginal cancer in women.

The newly approved vaccine called Gardasil — developed by Merck — protects against transmission of virus Types 6 and 11, which are believed responsible for 90 percent of disfiguring and difficult-to-treat genital warts, and against Types 16 and 18, responsible for 70 percent to 75 percent of cervical cancer — a disease that kills thousands of women a year in the United States and 250,000 women worldwide.

The U.S. fatalities are low due to widespread Pap testing, which can catch the disease in its earliest stages.

“Vaccine prevention strategies work when they are applied in a gender-neutral fashion,” Monk said in his article. “For example, polio, measles, tetanus, pertussis, diphtheria, rubella, mumps, and Haemophilus influenza B have been nearly eliminated in the United States as a result of this strategy.”

Hepatitis B infections have been reduced nearly 75 percent in the past 15 years by vaccinating high-risk infants at birth, all young children routinely, and high-risk, previously unvaccinated adults.

“Thus, HPV vaccination should be recommended to both boys and girls. Significantly, HPV vaccination of all females regardless of risk as well as vaccination of all boys has been shown to be cost effective with the primary benefit to vaccinating boys being realized through a reduction in transmission of HPV types 16 and 18 reducing to females thus reducing the risk of cervical cancer.”

Even though no test results have been published yet, Monk and co-author Dorothy Wiley, an epidemiologist and professor of nursing at the University of California, Los Angeles, believe that the vaccine should also be given to men. Janet Skidmore, a spokesperson for Merck, said studies are under way in men and results are expected soon.

“We suspect that those results will show the vaccine works as well in men as in women,” said Kevin Ault, associate professor of gynecology and obstetrics at Emory University in Atlanta.

“We also know that even in women who have been infected with one strain of human papillomavirus, the vaccine is protective against the other strains,” he told UPI. “The protection is reduced, but it still is effective in reduced rates.” He said that even protection against genital warts makes the virus worth taking.

“Treatment of genital warts is painful for the patient and the doctor,” Ault said. “It is difficult to cure, so there are often recurrences.” The three-dose vaccine will cost about $360 to administer, but Ault said that treatment of one episode of genital warts will cost a patients at least double that.

While taking the vaccine by men and women will further reduce the risk that anyone will get the disease, Ault noted that there are benefits to men aside from reduction of genital warts. “Human papillomavirus is know to be responsible for about 25 percent of head and neck cancers in men, and a high percentage of anal cancers,” he said.

Monk said arguments that a vaccine to human papillomavirus might lead to heightened sexual activity by young people are specious. Numerous studies have shown no increase in sexual activity with lessening restrictions on condoms.

“Seat belts do not cause reckless driving, tetanus shots do not cause children to seek out rusty nails, and hepatitis B vaccination has not altered sexual practices or increased injection-drug abuse in any population,” he said.

“Preventive measures do not always lead to high-risk behavior. It is naive to think that abstinence and monogamy will eradicate the morbidity and mortality of cervical cancer as suggested by some conservative organizations. Society needs to emphasize the benefits of HPV vaccination and find ways to increase its adoption and not create ill-founded barriers. Support and approval of HPV vaccination is not synonymous with support and approval of promiscuity, rather a cry to rally together to eradicate cervical cancer worldwide,” the authors said.