Important health news for mothers of boys.

UPDATE, DECEMBER 16, 2011: The Pharmaceutical Benefits Advisory Committee (PBAC) has for the first time recommended that boys between the ages of 12 and 13 be immunised against the Human Papillomavirus (HPV) and boys in Year 9 be given catch-up shots. PBAC has previously rejected calls for the school-based injection program to be extended to boys. The most common vaccination against some strains of HPV is Gardasil, developed in Australia. Here’s the official recommendation:

“The PBAC recommended extension of the National Immunisation Program listing of quadrivalent human papillomavirus (types 6, 11, 16, 18) (HPV) recombinant vaccine, solution for injection 0.5 mL, to include ongoing administration to males approximately twelve to thirteen years of age in a school-based program and for two catch-up cohorts for all males in the two year groups above the ongoing cohort, delivered over two years for Year 9 males, on the basis of acceptable cost effectiveness compared with female-only vaccination.”

The Government has to accept the recommendation if this is to become a reality, however. Watch this space.

Here’s our original story about why this is important news:

Your average boy might not have a cervix (right, none of them do) but that doesn’t mean boys and men shouldn’t be getting the cervical cancer vaccine.

Ongoing research into the effectiveness of the two vaccines known to prevent some strains of the Human Papillomavirus (HPV) suggests men (who also carry the virus) are also at risk of some cancers and genital warts.

The details can be a little confusing, so let’s step through this slowly.

Garadsil was developed by Australian of the Year Professor Ian Frazer after years of studying HPV. It protects against four strains of HPV. HPV16 and HPV-18 are responsible for almost three quarters of all cervical cancer cases in women and most of the cases of penile, anal, vulvar and vaginal cancers (which are, in truth, relatively rare).

But it also wards against HPV-6 and 11 strains which cause almost 9 in 10 cases of genital warts. Simply, genital warts are HPV.

It probably need not be mentioned that men can get anal and penile cancers. What isn’t mentioned quite so often is that HPV-related tonsil cancers happen almost as frequently in men as the cervical cancers do in women.

There are around 400,000 cases of cervical cancer in women worldwide, around half of which result in deaths.

The ‘peripheral’ cancers are not always nearly so deadly, but they can be. And, you guessed it, HPV can be spread by oral sex (and regular sex too, but oral sex with HPV transmission can lead to tonsil cancer).

And so, the case to get boys jabbed becomes a little clearer.

To gain an idea of just how widespread HPV is in men, a recent study found that as many as half the adult men in Brazil, Mexico and the United States carry HPV. And sure, the male cancers might be rare but in the US there were still 5000 new cases of anal cancer in 2010.

The fact remains that women get most of the cancer risk, but men are still never free from harm’s way either.

Especially gay men, who don’t benefit from the immunity of a woman who may have been vaccinated.

Take a look at this, from The Guardian in the United Kingdom:

“In most countries the vaccine is available for men who can afford to pay for it, but as far as I know it isn’t included in any vaccination programme. We’ll have to await further scientific evidence.

In the meantime it is worth highlighting the links between HPV infection and sexual behaviour. The more partners one has, the higher the probability of being exposed to someone with an infection. Scientists suspect that HPV infection has increased as a result of increased promiscuity since the sexual revolution of the 1960s.

If most of HPV infections occur at young ages, improving sexual education and awareness of sexually transmitted diseases would certainly help. One worry is that oral sex might be one way to pass on the virus. Hazel Nunn, senior health information manager at Cancer Research UK, says “oral cancer linked to HPV is a fascinating field of research” – but she emphasises that there are still many unanswered questions.”

In 2007, the Australian Government began funding a voluntary Gardasil vaccination program for girls from the ages of 12 to 26. This was scaled back to 12-13-year-old girls as part of the regular high school vaccination offering from 2009.

The vaccine is also approved for boys, but not funded. It costs about $400 if you’re after it outside of the Government allowances.

But really, for boys about to become sexually active, how much is peace of mind worth?

Professor Ian Frazer could not be reached for comment.

Have you been vaccinated with Gardasil? Have you vaccinated a child? A boy? Would you? What if it was funded by the Government?

NB: Gardasil does not protect against every cervical cancer and pap smears are still necessary for women who have been vaccinated, to be doubly sure.

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