Throat cancer surge prompts HPV jabs for boys rethink

Growing incidence of HPV-related throat cancer may make vaccinations for boys cost effective, researchers say.

An increase in throat cancer has prompted renewed calls for HPV jab for boys
An increase in throat cancer has prompted renewed calls for HPV jab for boys

Previous calls for boys to receive HPV vaccinations were rejected after it surpassed the upper threshold of NICE's cost-effectiveness benchmark - cost per 'quality adjusted life year' (QALY).

However, the UK has seen a 51% rise in incidence of oral and oesophageal squamous cell carcinoma in men, rising from seven per 100,000 to 11 per 100,000 between 1989 and 2006.

Researchers said this recent surge may alter the cost effectiveness argument and mean vaccination programmes for boys might be justified on health economic basis.

Writing in BMJ, Hisham Mehanna and colleagues at University Hospital, Coventry said the worldwide incidence of oesophageal squamous cell carcinoma caused by HPV has exploded in recent years, apparently due to a rise in HPV related tumours.

The authors said that HPV related oesophageal cancer appeared to be a 'new and distinct disease entity'. It does seem to have a more favourable prognosis than non-HPV related cancers but smoking worsens the outcome.

Researchers proposed that sexual transmission of HPV, through orogenital intercourse, may be responsible for the increased incidence.

The authors identified that, since patients with these cancers are often younger and employed, and as the prognosis is much more favourable than non-HPV related cancers, they will live longer with the outcome of their treatment.

‘Consequently, they need prolonged support from health, social, and other services, and may require help in returning to work,' they noted.

They said clinicians should not treat HPV related head and neck cancer any differently to non-HPV related. But they should aim to offer all patients with oesophageal cancer the opportunity to enrole in clinical trials to learn more about this association.

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