New scientific exploration raising the volume in talks about anal cancer, HPV and vaccination

Medill Reports
Northwestern University
Chicago

by Sarah V. White
Nov 03, 2010

It’s a cancer no one wants to talk about, but it might also be preventable.

Anal cancer, just like cervical cancer, is for the most part caused by the sexually transmitted disease HPV, and it is proving disproportionately prevalent in men who have sex with men.

It is a disease burdened by significant social stigma; actress Farrah Fawcett died of anal cancer in 2009, but media outlets skirted emphasizing the type of cancer she battled for three years.

But groups at a higher than normal risk for developing HPV-related anal cancer might benefit from HPV vaccines that already exist but are currently recommended only for young women.

Both vaccine manufacturers and gay health advocates are interested in the idea, while researchers are racing to catch up and explore whether vaccination is effective in preventing anal cancers in this population.

Two strains of human papillomavirus, or HPV, are linked to about 70 percent of cervical cancers and 80 percent of anal cancers in men. Both strains are in current vaccines against the virus, Gardasil and Cervarix.

Researcher Jane Kim, assistant professor in health decision science at the Harvard School of Public Health, designed a study to determine the efficacy of HPV vaccination with respect to anal cancer.

“If you could target men who have sex with men and not have to vaccinate all males,” Kim asked, “would this be a good health investment?”

The answer, according to Kim’s study, is yes.

Kim found a high degree of cost-effectiveness in vaccinating men who have sex with men against the high-risk HPV strains 16 and 18, which are linked to anal cancer, and low-risk HPV strains 6 and 11, which cause genital warts.

Her study, released Tuesday in The Lancet, addresses one pressing factor in public health vaccination recommendations – bang for the buck.

“Relative to vaccinating girls, vaccinating the general population of boys is not as cost-effective,” Kim said, mostly because anal cancers affecting males are not as widespread a public health concern as cervical cancers.

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