HPV vaccination of adolescent boys may be cost-effective for preventing oropharyngeal cancer

A new study indicates that vaccinating 12-year-old boys against the humanpapilloma virus (HPV) may be a cost-effective strategy for preventing oropharyngeal squamous cell cancer, a cancer that starts at the back of the throat and mouth, and involves the tonsils and base of the tongue. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study provides important information about HPV vaccination, which has proven effective against HPV-related disease in both sexes but remains controversial, especially in males.

Many western countries have established female HPV vaccination programs for preventing cervical cancer. Little is known about the cost-effectiveness of male-HPV vaccination, however. Donna Graham, MB, BCh, MRCPUK and Lillian Siu, MD, FRCPC, of the Princess Margaret Cancer Centre, University Health Network, in Toronto, led a team that compared the potential costs and effectiveness of vaccinating adolescent boys in Canada against HPV for preventing HPV-related oropharyngeal cancer. When the investigators applied a statistical model to a population of 192,940 Canadian boys who were 12 years old in 2012, they found that HPV vaccination could save from $8 million to $28 million Canadian dollars over the boys' lifetimes. Factors that could impact the cost savings of HPV vaccination in boys include, among others, vaccine cost, vaccine effectiveness, costs of cancer treatment, and survival of patients with HPV-related oropharyngeal cancers.

"We believe this study is important because HPV-related oropharyngeal cancer has increased significantly in incidence, especially in developed countries," said Dr. Graham. "It is projected that by 2020, HPV-related oropharyngeal cancer will become the most common HPV-related cancer in the US, surpassing cervical cancer."

Policy makers in many countries such as the United States, Canada, Austria, and Australia have recommended HPV vaccination in boys, but it is unfunded and is excluded from national immunization programs in many countries worldwide, notes Dr. Siu. "We hope that results from this study would raise awareness and lead to further assessment of this important public health issue," she said.