Young gay men should be given a vaccine only used to cut cervical cancer among women because they are 15 times more likely than heterosexual men to suffer from genital cancers, British medical researchers have said.
The use of the vaccine to cut human papillomavirus infection (HPV) numbers among 16- to 26-year-old males would be “cost effective”, researchers from the Royal Liverpool University Hospital, Homerton University Hospital, and Chelsea and Westminster Hospital say.
"Men who have sex with men are disproportionately affected by HPV-related cancer, particularly anal cancer, where rates are over 15 times higher than in heterosexual men," say the authors, who are published by Sexually Transmitted Infections, an official journal of the British Association of Sexual Health and HIV.
“The offer of HPV vaccination would give focus to initiatives to improve access for young gay men who remain at the greatest risk of acquiring HIV, and may increase willingness to attend a sexually transmitted infection service, and to disclose sexual orientation.
"There is now ample data testifying the increased burden of HPV-related conditions and cancer in MSM [men who have sex with men]. The introduction of national cervical cancer screening programmes have contributed to significant falls in cervical cancer rates and associated mortality," they say.
Vaccination programme
The National Health Service in the UK began a vaccination programme against HPV infection in 2008, but only among girls – on the grounds that this would curb the spread of the infection to boys as well. The evidence from Australia shows that a similar vaccination effort there has led to "a dramatic decline" within just a year in the incidence of genital warts among straight men, but there has been no similar fall in numbers among gay men, the authors say.
Last February, the Australian medical authorities began to extend its HPV vaccination programme to 12- to 13-year-old boys, along with starting a catch-up programme for those two and three years older.
Recent research has shown that the HPV jab is effective in men, including gay men. The vaccine covers HPV 16 and 18, the two strains of the virus which account for most of the cancers associated with the infection,” it says.
The vaccine is most effective for those not already infected with these strains of HPV – though the evidence to date shows that only a minority of young gay men are so infected.
