June is Men’s Health Awareness Month. Whether or not you provide direct care for men, you can play an important role in one aspect of men’s health: working to eliminate HPV-associated cancers. According to the CDC, about 15,800 men in the United States are diagnosed each year with HPV-associated cancers.1 Eighty percent of these men are found to have oropharyngeal cancer (base of tongue, tonsils, pharynx) and 20% are found to have penile, rectal, or anal cancer.
These cancers typically develop slowly over several years or even decades after HPV infection occurs. According to the CDC, with respect to HPV-associated cancers in men, the median age at diagnosis was 61 years for oropharyngeal cancer, 69 years for penile cancer, and 59 years for anal cancer.2 Most men with recently diagnosed HPV-associated cancers did not have the HPV vaccine (approved for use in males in 2009) available to them to prevent infection when they first became sexually active as adolescents or young adults.
Today we have an HPV vaccine approved for males and females that prevents infection by all seven of the high-risk HPV types associated with cancer, as well as the two low-risk types of HPV responsible for genital warts. Although HPV vaccination rates are improving, those in males continue to lag behind those in females: According to 2017 CDC data, 53.1% of girls aged 13-17 were up to date with the recommended HPV vaccination series, as compared with 44.3% of boys aged 13-17.3
Current recommendations for males include routine vaccination at age 11 or 12.4 Catch-up vaccination is recommended for males aged 13-21 who have not completed the vaccine series. In addition, vaccination is recommended through age 26 for males not adequately vaccinated previously who fall into any of these categories: men who have sex with men, individuals who are transgender, and individuals who have certain immunocompromising conditions.
A call for action: If you see adolescent and/or young adult males in your practice, ask them if they have completed the HPV vaccination series. If not, and when indicated, urge them to get vaccinated at that time. Because young males are not as likely as young females to seek regular reproductive/sexual healthcare, we must advocate for HPV vaccination for both males and females at every opportunity. When providing the vaccine to females, let them know why young males should get vaccinated too. When performing cervical cancer screening or discussing cervical cancer screening recommendations with female patients, let them know that the HPV vaccine that prevents cervical cancer also prevents several types of cancer in males. Offer your patients written information such as the CDC’s HPV and Men – Fact Sheet. With a concerted effort to get all preteen, adolescent, and young adult males HPV vaccinated, when these individuals reach age 40 and beyond, the cancer statistics for men should look much different than they do today.
Beth Kelsey, EdD, APRN, WHNP-BC, FAANP
1. Viens LJ, Henley SJ, Watson M, et al. Human papillo-mavirus-associated cancers – United States, 2008-2012. MMWR Morb Mortal Wkly Rep. 2016;65(26):661-666.
2. CDC. HPV and Cancer. HPV-Associated Cancer Diagnosis by Age. Page last reviewed August 16, 2018. cdc.gov/cancer/hpv/statistics/age.htm
3. Walker TY, Elam-Evans LD, Yankey D, et al. National, regional, state, and selected local area vaccination coverage among adolescents ages 13-17 years – United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67(33):909-917.
4. CDC. Vaccines and Preventable Diseases. HPV Vaccination Recommendations. Page last reviewed December 28, 2016. cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html