Canadian study provides new evidence for the cost effectiveness of vaccinating boys for the human papilloma virus (HPV) to prevent oral cancer.

First licensed for use in 2006, the HPV vaccine is now recommended in several Western countries for girls aged 9 to 12 as a cost-effective measure in the prevention of cervical cancer.

A number of public health professionals have suggested the vaccine might also be administered to boys, namely to help reduce the risk of oropharyngeal cancer. Tumors leading to this type of cancer, which develops in the back of the throat and affects the tonsils and the base of the tongue, can be caused by certain strains of HPV.

But recommending the vaccine to boys remains controversial, namely due to uncertainty over cost-effectiveness.

Researchers at the Princess Margaret Cancer Center in Toronto set out to change this. In a study published in the journal Cancer, they offer a convincing economic argument for vaccinating adolescent boys.

The research team started by reviewing existing data on the frequency of oral cancer in males, related healthcare expenditures and the efficacy of the HPV vaccine in preventing these cancers. Using this data, the researchers developed a statistical model which they applied to a population of 192,940 Canadian boys who were 12 years old in 2012.

According to their results, HPV vaccination could result in savings of between 8 and 28 million Canadian dollars over the boys’ lifetimes.

Given a supposed vaccination rate of 70% and vaccine effectiveness of 90%, the savings would be equivalent to around 145 Canadian dollars per patient.

Oral cancers account for 78% of HPV-related cancers in men. Faced with an increased incidence of the disease, certain countries including the US, Switzerland, Austria and Australia have considered vaccination programmes for boys. For the time being, however, the vaccine is not part of the official recommended immunisation schedule in any of these countries and is not typically covered by health insurance plans.

Another argument among researchers for the widespread vaccination of boys is to help prevent the spread of HPV itself, as the rate of vaccination among girls remains relatively low in most countries.

However, researchers stress that as the vaccine is relatively recent, it will be at least 25 years before its effectiveness in the prevention of cancer can be fully demonstrated.

Last year, the British Medical Journal published two studies suggesting the effectiveness of male HPV vaccination in the prevention of genital warts. The HIM study (HPV Infection in Men), published in The Lancet in July 2013, indicated that the link between HPV and oral cancer was stronger in single men who were also smokers. – AFP Relaxnews