OTTAWA – Researchers are seeing an unexpected and unexplained rise in the number of cancer cases in men caused by the Human papillomavirus (HPV), according to a recently released report from the Canadian Cancer Society.
The report, released on Oct. 19, found that cancers in the head and neck are on the rise in men, but doctors don’t know why, according to Alberto Severini, chief of the viral sexually transmitted diseases (STDs) and exanthemata section at the Public Health Agency of Canada.
“It was unexpected and there are speculations but in reality we don’t know why it’s going up,” Severini said.
HPV is a sexually transmitted disease that is spread by skin-to-skin contact, according to Severini. The disease causes wart-like growths and lesions on the infected area, which can become cancerous. Certain strains of the disease can lead to cervical cancer in women but can also affect a person’s genitals and throat. While most infections clear up without any issue, Severini said it is the cases that persist for many years that can cause cancer.
Girls have been able to get vaccinated against HPV in Grade 7 in Ontario schools since 2007 and boys have been able to get the vaccine since September 2016, according to the Ontario Ministry of Health and Long-Term Care. In Alberta, Manitoba, Ontario, Quebec, Prince Edward Island, and Nova Scotia boys are now being vaccinated. To date, 5.3 million doses of the vaccine have been given in Canada, according to the report.
“Obviously there was something happening with the infections in men 15 or 20 years ago which maybe is continuing now, which is contributing to this increase.”— Alberto Severini
Overall, the report states that in 2012, 3,760 Canadians were diagnosed with cancer caused by HPV and this number will rise to 4,375 this year. Male cases of HPV-related cancers made up a third of the total cancer cases caused by HPV in Canada, but cases of head and neck cancers were four and a half times higher in men than in women in 2012.
Brianne Wood, a PhD student at the University of Ottawa researching HPV, said the increase in men could be related to smoking and alcohol consumption.
“It’s not a direct ‘if you’re smoking, you’re going to get HPV cancer’ but there might be some mechanism going on,” she said.
Wood said it is possible that smoking causes an HPV infection to persist longer than it normally would, which is when cancer could develop. The Canadian Cancer Society’s report echoes this and says it is “likely” that the number of HPV-caused head and neck cancers in men is because of a history of higher tobacco use.
In 2012, cervical cancer, which is always caused by HPV, made up 40 per cent of deaths from the disease, the largest single cause, the report says. Cancer in the head and neck came in second and represented 30 per cent of deaths from HPV.
Severini said the rise in HPV-related cancers shows that something was happening with the disease in the past, as it takes time for cancer to develop.
“Obviously there was something happening with the infections in men 15 or 20 years ago which maybe is continuing now, which is contributing to this increase,” he said.
Cervical cancer can be screened for but other types, such as in the head and neck, cannot be, Severini said. This is due to the anatomy of the mouth as it hard to get a sample from one area that represents the whole thing.
While cases of HPV-related cancer are increasing in men, the HPV vaccine has been proven to prevent the disease in both genders, said Eduardo Franco, chair of the department of oncology at McGill University.
Franco said the decision to vaccinate boys against HPV in 2016 has accelerated the process of protecting people from the disease.
“The initial take on this is that it would not be cost effective to vaccinate men because of the tremendous cost we pay in Canada for the vaccine,” he said. “It’s a moot point now because the cost of the vaccine has reduced substantially so we can easily afford [it].”
Girls have been able to get vaccinated against HPV in Grade 7 in Ontario schools since 2007 and boys have been able to get the vaccine since September 2016.— Ontario Ministry of Health and Long-Term Care.
Franco said that Canadians pay more for the vaccine because Canada is a “top tier” country and can afford the cost. As a result of this, the vaccine can be sold in developing countries for a much lower price. An article from the CBC states the vaccine in Canada could cost up to $200 but in developing countries it is around $5.
Severini agreed with Franco, but said there is some resistance to the vaccine in Canada.
“The one thing about HPV that has been a problem has been the acceptance of the vaccine,” he said. “For some reason the HPV vaccine is not well received by parents and recipients.”
He added that the number of people who get the vaccine is lower than he would like it to be, but he does not know why people are hesitant to get it.
While the rates differ between provinces, Newfoundland and Labrador have the highest vaccination rate, 93 per cent, while the Northwest Territories have the lowest, 47 per cent, according to the report.
Franco said that even though the report from the Canadian Cancer Society shows head and neck cancer on the rise in men, it gives Canadians a clear idea of how much of the disease can be prevented.
“It’s good news,” Franco said. “We’re kind of tired of seeing bad news with cancer so it’s always a good idea to show one of the most exciting areas in all of cancer prevention.”
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