THE number of serious head and neck
cancers linked to a virus spread by oral sex is rising rapidly and
suggests boys as well as girls should be offered protection through
vaccination, doctors say.
Despite an overall slight decline in most head and neck cancers in
recent years, cases of a particular form called oropharyngeal squamous
cell carcinoma (OSCC) have increased sharply, particularly in the
developed world.
This growth seems to be linked to cancers caused by the human papillomavirus (HPV), the scientists said in a report in the British Medical Journal.
Two
vaccines - Cervarix, made by GlaxoSmithKline, and Gardasil, made by
Merck & Co - can prevent HPV, which causes virtually all cases of
cervical cancer, the second most common cancer in women worldwide.
Many
rich nations have launched HPV immunization programs for girls to try
to protect them from the common sexually transmitted virus before they
become sexually active.
The scientists, led by Hisham Mehanna of the Institute of Head and
Neck Studies at Britain's University Hospital Coventry, said that while
including boys in immunisation plans was previously seen as too
expensive, it may be time to look again.
"We need to look at the
evidence again to re-evaluate the cost-effectiveness of male children in
light of this new and rapidly rising incidence," he said in a telephone
interview.
More than 500,000 cases of cervical cancer are
diagnosed annually in women and it kills around 200,000 a year. Head and
neck cancer is the sixth most common cancer among men and women, with
about 640,000 new cases each year worldwide.
A recent study found
the risk of developing oropharyngeal carcinoma was linked to a history
of six or more lifetime sexual partners, four or more lifetime oral sex
partners, and, for men, an earlier age at first sexual intercourse.
"Sexual
transmission of HPV - primarily through orogenital intercourse - might
be the reason for the increase in incidence of HPV related oropharyngeal
carcinoma," wrote Mehanna.
The experts pointed to recent studies
which showed a 70 per cent increase in the detection of HPV in biopsies
taken to diagnose oropharyngeal carcinoma in Stockholm since the 1970s.
HPV-related
cancer was also reported in 60 to 80 per cent of recent biopsy samples
in studies in the United States, compared with 40 per cent in the
previous decade, they wrote.
Mehanna said the findings had other important health implications.
Patients
with HPV-related head and neck cancers are typically younger and
employed, he said, and because their tumors appear to be less deadly
than those caused by factors like smoking and drinking, patients may
also live longer with the physical and psychological effects of
treatment.
"This means they would need prolonged support from
health, social, and other services, and may require help in returning to
work," he wrote.
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