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HPV Vaccine: Cost-effective Way to Prevent Anal Cancer

Study Shows Benefits of HPV Vaccine in Men Who Have Sex With Men
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Who Should Get the HPV Shot? continued...

"Such a strategy is very likely to be a valuable health investment for a high-risk population that otherwise relies on no other organized prevention strategy against an illness with a high disease burden," she writes.

Younger men may not be aware of their sexual identity or willing to disclose it, and this is one of the reasons some experts were calling for routine vaccination of all boys.

"Programs targeting HPV vaccination of males who have sex with other males at older ages -- when more men have established and are willing to disclose their sexual identity -- might be a good approach to reach this high-risk group," she says.

Vaccine Programs

"The risk of anal cancer is higher in men who have sex with other men, and there is no routine screening program in place," says Joel Palefsky, MD, a professor of medicine at the University of California at San Francisco. He wrote an editorial accompanying the new study.

"From a health standpoint, it is clear that this vaccine works pretty well to prevent anal warts and likely anal cancer," he tells WebMD. "The implementation of a vaccination program would be the only organized prevention effort available."

Some of the details still need to be worked out.

"Most men who have sex with men will not be self-identified or have identified themselves to their primary care providers at the age of 12, and we would hope males would be vaccinated as early as possible," Palefsky says.

That said, "the vaccine would be cost-effective up to the age of 26 when a much bigger chunk of men who have sex with men would be self-identified," he says.

Vaccine Recommendations

"I am optimistic that FDA and the Advisory Committee on Immunization Practices (ACIP)  will agree that anal cancer is a worthwhile indication for this vaccine in men and women, and the real question is should it be recommended for routine use in boys," Palefsky says. 

"The vaccine won’t get serious uptake in males unless it is included in the routine vaccine schedule, but my crystal ball is not clear enough to predict that at this time," he says. The ACIP, which advises the CDC on vaccine matters, is currently reviewing the data and expected to make its recommendations soon.

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