American Cancer Society Updates HPV Vaccine Recommendations to Include Males

7/19/2016, American Cancer Society

The American Cancer Society has updated its guideline for human papilloma virus (HPV) vaccination to include males. The change makes the guideline largely consistent with US government recommendations. The Advisory Committee on Immunization Practices (ACIP), part of the US Centers for Disease Control and Prevention (CDC), is the main source for US immunization policy.

Almost everyone who is not vaccinated will get HPV at some time in their lives, and most will never know it. HPV is transmitted through sexual contact. The infection usually goes away on its own and doesn’t cause health problems. But in some cases HPV doesn’t go away. Some types of HPV can cause genital warts, while other types can lead to cancer. The HPV vaccines used most often in the United States prevent infection by both of these types of HPV. Almost all cervical cancer is caused by HPV. The virus has also been linked to cancers of the vulva, vagina, penis, anus, and throat.

“HPV vaccination has the potential to prevent tens of thousands of cancers and hundreds of thousands of pre-cancers each year,” said Debbie Saslow, PhD, director of cancer control intervention for HPV vaccination and women’s cancers at the American Cancer Society. “It is critical that all the stakeholders here—families, health care providers, and others—make HPV vaccination a priority, so that prevention of the vast majority of cervical, vaginal, vulvar, anal, penile, and oropharyngeal [throat] cancers can become a reality.”

According to the CDC, more HPV-linked cancers have been diagnosed in recent years. The CDC looked at data recently from population-based cancer registries and found almost 31,000 new cases of cancer each year from 2008 to 2012 were attributable to HPV. The CDC says vaccination could potentially have prevented about 29,000 of those cancers from occurring.

Who should get the vaccine?

The HPV vaccine is given as a series of 3 shots, typically within 6 months. Girls and boys should ideally begin getting the vaccine series at age 11 or 12. The vaccine causes a better immune response at this age than during the teenage years. Children are also likely still seeing their doctor regularly and getting other vaccinations at this age.

For the HPV vaccine to work best, it is also important to get it before you are ever exposed to the virus. That’s why the vaccine is recommended for children before they grow up and become sexually active. The vaccination series can be started as early as age 9.

For those who did not get vaccinated at age 11-12, or who did not complete the 3-dose series, the recommendation is that females ages 13-26 and males ages 13-21 be vaccinated. Men can also get the vaccination up to age 26. However, the vaccine is not as effective in lowering cancer risk in men or women after age 21.

Why did ACS change its guideline?

When the ACS first recommended HPV vaccination in 2007, the vaccine was not approved for use in males, and there was not enough evidence for recommending vaccination after age 18. Since then, new studies have provided more evidence, new HPV vaccines have been developed, and the ACIP has issued new immunization recommendations.

Studies now show that vaccination in males is effective in preventing HPV infection. New evidence has also allowed the ACS to make recommendations for vaccination through age 26.

Summary of new American Cancer Society guideline for HPV vaccination

• Boys and girls should begin HPV vaccination at age 11 or 12, but can begin as early as age 9.
• Vaccination is also recommended for females ages 13 to 26 and for males aged 13 to 21 who have not had all 3 shots. Men 22 through 26 years old may also be vaccinated.
• Men and women ages 22 to 26 can get the vaccine, but at this age it may be less effective in lowering cancer risk.
• Vaccination is recommended through age 26 for men and women with weakened immune systems, including those with HIV infection.
• Vaccination is recommended through age 26 for men who have sex with men.

The full guidelines were published early online July 19, 2016 in CA: A Cancer Journal for Clinicians.

Citation: HPV Vaccination Guideline Update: American Cancer Society Guideline Endorsement. Published early online July 19, 2016 in CA: A Cancer Journal for Clinicians. First author Debbie Saslow, PhD, American Cancer Society, Atlanta, Ga.

 

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