A whopping four out of five Canadians will get HPV (human papillomavirus) at some point in their lives, and while it’s the most common sexually transmitted infection in the world, we still have a lot to learn about it. Many types of HPV have been identified, with some leading to cancer and others to skin lesions, and we know that HPV infection causes more than 99% of cases of cervical cancer. But more research is showing that the infection is also linked to cancer of the throat, oral cavity, penis, anus, vagina and vulva.
According to the Canadian Cancer Society, in Canada, about two-thirds of HPV-related cancers happen in areas other than the cervix. HPV infection is related to 80% to 90% of anal cancers; 40% to 50% of penile cancers; and now more than 70% of mouth and throat cancers. The research around the oncogenic or cancer causing viral types continues, but one thing we know for sure is that HPV prevention and vaccination isn’t just a conversation that women and young girls must be having, but males too.
HPV is spread through intimate skin-to-skin contact. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. Most commonly spread during vaginal or anal sex, HPV can be passed from person to person even when an infected person has no signs or symptoms of infection. Anyone who is sexually active can contract the virus, even if they have only had sex with one person. To reduce the risk of HPV related cancers, the Canadian Cancer Society recommends the HPV vaccine in females aged 9 to 45 and in males aged 9 to 26. The National Advisory Committee on Immunization, the Canadian national guidelines committee, suggests that even men and women older than 26 and 45, respectively, should speak to their doctor and consider the vaccine. This is because risk depends on exposure, not age.
“Most providers still think of this as a woman’s thing,” says Dr. Nancy Durand, a gynecologist at Toronto’s Sunnybrook Health Science Centre, “but the latest evidence makes it clear, we should discuss HPV with every single patient.” New studies are indicating that HPV prevention and vaccination should be just as high a priority for men as it is for women. According to Canadian Cancer Statistics 2016, mouth and throat cancers from HPV (which now make up a third of all HPV-linked cancers) have increased 56% in men since the mid-1990s. Men are up to 4.5 times more likely to be diagnosed with these oropharyngeal cancers than women.
What’s more, cancers of the mouth and throat caused by HPV are rising dramatically among Canadian men and are poised to surpass the rate of cervical cancer in women, according to a report released by the Canadian Cancer Society. Even more sobering news for women: according to Canadian Cancer Statistics, the rate of anal cancers from HPV is increasing at an average of 3% per year, “the number of anal cancers in women is now surpassing men, including gay men,” Durand said.
HOW TO PREVENT HPV
HPV vaccines help protect against HPV infection and associated cancers. There are three types of vaccines to protect against HPV infection in Canada – Cervarix, Gardasil 4 and Gardasil 9 – click here to learn more.
One thing is clear: HPV prevention and vaccination is a highly relevant issue for both men and women, but there is still a fair amount of confusion around the virus, its causes, and its consequences. Many Canadians may not be vaccinated against HPV because their doctors are not up to date with the latest research on risk, and the details about the virus. “Many providers still think of this issue as a problem for young promiscuous patients,” says Durand. Some doctors assume vaccination is only necessary for children who are not yet sexually active or younger patients who are more likely to change sexual partners more often. While vaccination is most effective when given to individuals before they become sexually active, that doesn’t mean that older patients should not be vaccinated too. Canadians are marrying later in life and more than a third of marriages end in divorce “If you’re over the age of 30, your five-year risk of acquiring HPV is more than 20%,” said Durand, “Over the age of 45, you still have more than a 10% risk.”
An additional challenge faced in the fight against HPV linked cancers is the fact that, unlike pap screening for cervical cancer, there is no equivalent regular screening program in place for oropharyngeal cancers linked to HPV. Currently cervical pap screening is the only method for detecting HPV, which means that men with HPV “fly under the radar,” and the virus goes undetected. This is why vaccination for both men and women is critical, and the earlier the better. The HPV vaccine is widely available through publicly-funded, school-based programs. It’s now offered to boys and girls in all provinces and territories.
Once you are out of the school system, the government no longer pays for the vaccine, but that doesn’t mean it is not still really important. We have lots of guidelines in society that are recommended, but unfunded, such as carseats or bike helmets. Let’s protect ourselves, our children, and our partners, and decrease the risk of cancer.
Whatever age or sex you are, it’s important to talk to your doctor and your children about HPV prevention and vaccination. Understandably, this can be an uncomfortable topic to discuss, which is why we make it easy with Medisys On-Demand, our virtual care platform. You and your immediate family members can talk confidentially with healthcare professionals about HPV causes, symptoms, prevention and vaccination, all in the privacy and comfort of your own home. To begin that discussion now, or learn more about our virtual care services, click here.