Should Boys Be Vaccinated Against HPV Infection?

Human papillomavirus (HPV) infection is the leading cause of cervical cancer among women today. However, research published February 1, 2008 indicates that HPV is also the leading cause of cancer of the tonsils, lower tongue, and upper throat (Chaturvedi, Engels, Anderson, & Gillison, 2008). The rates of HPV-related oral cancer have increased consistently in men from 1973 to 2004, such that it is now as prevalent as oral cancer caused by tobacco and alcohol. Approximately, 5600 cases annually may be attributed to infection with HPV. The increasing prevalence of HPV-related oral cancer in men may be due to the increasing frequency of oral-genital sex, in addition to the decreasing rates of tobacco use. HPV-related oral cancer has actually declined in the same time period for women.

Currently, a vaccine to prevent HPV infection, produced by Merck & Company, Inc., is only authorized by the federal government to be administered to girls, because early research focused on the risk of cervical cancer in women. However, the recent research suggests an additional reason that HPV vaccination should begin for boys as well. In fact, Merck plans to seek federal authorization for boys in the near future. In addition to oral cancer, HPV infection is also linked to increased risk for genital warts, penile cancer, and anal cancer. The recent research by Merck has only focused on the latter types of cancer, not oral cancer (Stobbe, February 1, 2008).

All of these findings lend support to arguments that boys should be vaccinated at early ages, along with girls. The vaccine is more effective if it is administered prior to HPV infection, which is the rationale for vaccinating individuals at an early age before they have first engaged in sexual behavior. Initially, the proposal to vaccinate boys was based on concern about reducing the spread of HPV to women because of its role in increasing risk of cervical cancer. With evidence indicating that HPV is associated with higher levels of oral, penile, and anal cancer among men, the vaccination of boys against HPV infection is even more compelling.

The proposal to vaccinate young girls, however, has already inflamed a good deal of controversy in a number of states and communities around the U.S. It is likely that the movement to vaccinate boys will meet with the same type of disapproval by some people.

What is your view about the issue of vaccinating girls and boys for HPV infection? Why do you suppose some people are upset about the prospect? Is it more important to protect individuals from factors known to cause cancer, or to avoid the issue because it is related to sexual behavior?

Chaturvedi, A. K., Engels, E. A., Anderson, W. F., & Gillison, M. L. (2008). Incidence trends for Human Papillomavirus–related and –unrelated oral squamous cell carcinomas in the United States. Journal of Clinical Oncology, 26, 612–619.

Stobbe, M. (February 1, 2008). HPV causing more oral cancer in men. Retrieved February 2, 2008, from http://ap.google.com/article/ALeqM5ip7PfN_mm2RrKX-AyRKDX9FNzzNwD8UHQ3KG0