Source: RadioAustralia.net
Author: Staff

It is already available free to young girls in countries like Nauru, Vanuatu, Tuvalu and Cook Islands, but researchers are now saying the human papilloma virus, or HPV, vaccine Gardasil should also be offered to males.

It follows new Australian research showing that the virus which causes cervical cancer in women is now a leading cause of oral cancer in men. It says 60 per cent of throat and tonsil cancers are caused by the virus.

Presenter: Lindy Kerin
Speaker: Barbara Rowe, associate professor in research with University of Sydney; Luke Connolly, director of Australian Centre for Economic Research; Dr Jonathan Clark, head and neck surgeon with Royal Prince Alfred and Liverpool Hospitals, New South Wales

LINDY KERIN: For the past two years Australia has been rolling out the cervical cancer vaccine Gardasil to young women. It immunises them against the human papilloma virus, or HPV as it’s known. Now there’s growing evidence that the same virus is responsible for an increasing number of mouth and throat cancers in men.

Barbara Rowe is an associate professor in research at the University of Sydney.

BARBARA ROWE: We’ve tested just over 300 cancers of the oropharynx, and the oropharynx includes the tonsil and the base of tongue and part of the pharangyl wall. And we’ve tested those for the human papilloma virus type-16 and type-18, which the major cause of cervical cancer in women. And we found a sizeable proportion are associated with those types. In fact probably in excess of 50 per cent now.

LINDY KERIN: Those figures from 2001 to 2005 increased to almost 60 per cent in 2006 and 2007. Associate Professor Rowe says head and neck cancers have traditionally been associated with older men and related to alcohol and smoking. She says these findings show that has now changed and most likely due to the increasing practise of oral sex.

BARBARA ROWE: We now know that there’s another subset, which is quite distinct biologically, which tends to affect younger people who don’t smoke and don’t drink, caused by human papilloma virus, probably by sexual transmission. And the types of papilloma virus that are associated are type-16 and 18 which are cause cervical cancer, the major cause of cervical cancer.

LINDY KERIN: Associate professor Rowe says the findings should prompt discussions about extending the vaccination program to boys.

BARBARA ROWE: The paper that we just published gives some indication of the numbers of cancers that would be potentially preventable down the track by vaccinating boys.

LINDY KERIN: Dr Jonathan Clark is a head and neck surgeon at Royal Prince Alfred and Liverpool Hospitals in New South Wales. He says the rate of HPV cancers in men is increasing.

JONATHAN CLARK: At the moment we’re trying to come to grips with what it means and how it changes our approach to managing these types of cancers. The evidence is very strong that if you have the human papilloma virus causing this sort of cancer, in fact your prognosis is better than if the cancer is caused in the typical fashion which is due to smoking.

LINDY KERIN: Dr Clark says extending the vaccination to boys is worth considering and is worthy of further research which could take some time.

JONATHAN CLARK: Even if there’s research today, tonsil cancers occur in an older group of patients. Though HPV positive tonsil cancers tend to occur in younger people who don’t smoke. But they develop over many years. So it is going to take quite a bit of time to see whether the introduction of the HPV vaccine actually has an effect of reducing the rate of tonsil cancer.

LINDY KERIN: Researchers say the cost-effectiveness of extending the program to boys needs to be analysed.

The director of the Australian Centre for Economic Research on Health is Luke Connolly.

LUKE CONNOLLY: What needs to be done is the models that researchers like myself and others are using need to be extended to try to cover these additional types and the impact of the vaccine on these types. That’s not always particularly easy to do but there’s now sufficient data I think to allow us to start down that path to assess the effectiveness of the vaccine, the cost-effectiveness of the vaccine for boys.