OBJECTIVE: To assess the reduction in the vaccine preventable burden of cancer in men if boys are vaccinated along with girls against oncogenic human papillomavirus (HPV).
DESIGN: Bayesian evidence synthesis approach used to evaluate the impact of vaccination against HPV types 16 and 18 on the burden of anal, penile, and oropharyngeal carcinomas among heterosexual men and men who have sex with men. The reduced transmission of vaccine-type HPV from vaccination of girls was assumed to lower the risk of HPV associated cancer in all men but not to affect the excess risk of HPV associated cancers among men who have sex with men.
SETTING: General population in The Netherlands.
INTERVENTION: Inclusion of boys aged 12 into HPV vaccination programmes.
MAIN OUTCOME MEASURES: Quality adjusted life years (QALYs) and numbers needed to vaccinate.
RESULTS: Before HPV vaccination, 14.9 (95% credible interval 12.2 to 18.1) QALYs per thousand men were lost to vaccine preventable cancers associated with HPV in The Netherlands. This burden would be reduced by 37% (28% to 48%) if the vaccine uptake among girls remains at the current level of 60%. To prevent one additional case of cancer among men, 795 boys (660 to 987) would need to be vaccinated; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2162, 3486, and 1975, respectively. The burden of HPV related cancer in men would be reduced by 66% (53% to 805) if vaccine uptake among girls increases to 90%. In that case, 1735 boys (1240 to 2900) would need to be vaccinated to prevent an additional case; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2593, 29107, and 6484, respectively.
CONCLUSIONS: Men will benefit indirectly from vaccination of girls but remain at risk of cancers associated with HPV. The incremental benefit of vaccinating boys when vaccine uptake among girls is high is driven by the prevention of anal carcinomas, which underscores the relevance of HPV prevention efforts for men who have sex with men.
Written by:
Bogaards JA, Wallinga J, Brakenhoff RH, Meijer CJ, Berkhof J. Are you the author?
Department of Epidemiology and Biostatistics, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, Netherlands; Department of Otolaryngology/Head and Neck Surgery, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, Netherlands; Department of Pathology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, Netherlands.
Reference: BMJ. 2015 May 12;350:h2016.
doi: 10.1136/bmj.h2016
PubMed Abstract
PMID: 25985328