While anal cancer rates have risen dramatically in the past four decades, the UK government is still dithering on whether to give young men a vaccine that could protect them.
New figures published this month by the leading UK cancer charity Cancer Research UK show that anal cancer rates in Britain have rocketed since the mid 70s. In total, anal cancer incidents have gone up 374% for women, and 202% for men. To put that in a more quantifiable way, just o.4 in every 100,000 people were known to develop anal cancer in the mid 70s. That figure is now at 1.5 out of every 100,000 today. The death rate also appears to have quadrupled, with roughly six people dying every week from anal cancer in the UK.
Anal cancer is a relatively uncommon disease, so even with this scary sounding rise, it’s important to put that in context. What’s more, the rise in the rates of anal cancer diagnoses may be at least partially attributed to better screening practices. It’s still difficult to catch anal cancer early on, partially due to the stigma attached to that region of the body and also the fact that the initial symptoms aren’t always obvious, but doctors are catching the disease and far earlier than before.
However, that doesn’t account for such a big increase — so what does? Smoking seems to increase the risk of several cancers, including anal cancer. Quitting should therefore be a priority. Experts also say they think one sexually transmitted disease might be to blame: the human papillomavirus (HPV).
Just as HPV transmission is a known risk factor for women developing cervical cancer, it appears that HPV could be linked to up to 90% of anal cancer cases, and while condoms can help to prevent transmission, they are not able to give us complete protection. The HPV vaccine, therefore, is a vital tool in stopping anal cancer in its tracks.
“Anal cancer is closely linked to HPV, and changes in sexual attitudes mean people are increasingly exposed to the virus. We’re not suggesting people take a vow of celibacy, but HPV vaccination, using a condom and being a non-smoker can all help to reduce the risk,” Jessica Kirby, senior health information manager at Cancer Research UK, is quoted as saying.
The reason why the jump in anal cancer rates appears to affect women more than men is unclear, but women in the UK are at least helped by the fact that teenage girls now routinely receive the HPV vaccine, thus helping to protect them from the virus and decreasing their risk of a number of cancers. Cancer Research UK says that this relatively recent change is likely to impact anal cancer rates among women and help to bring down that figure over the coming decade.
However, despite HPV being a possible risk factor for cancers in men, and particularly for gay men, the British government has so far resisted rolling out the immunization program to teenage boys — even though a number of other nations do provide the immunization, including Australia and the United States, and that a number of major medical bodies have recommended the change.
Currently, Britain’s Joint Committee on Vaccination and Immunisation (JCVI) is considering adjusting the policy to cover at least some young men. This isn’t just good for boys (or girls) who receive the immunization. As we’ve detailed before here at Care2, immunization creates herd immunity. This means that, for those people who for whatever reason cannot be vaccinated, they are protected by the majority of other people being vaccinated and are therefore far less likely to catch the virus.
In addition to this, the fact that men who have sex with men (MSM) are at higher risk of various cancers like anal, throat and penile cancer, and that they have all been linked to HPV, demonstrates that the cost of the immunization could help to pay for itself by the long-term reduction in health care costs for treating those cancers. Predictive models based on cervical cancer at least say that these campaigns can be successful, so the risk on that investment can be absorbed.
On balance, there appears to be no evidence-based reason to deny men what could be a life-saving vaccine, and every reason to move forward on it. It’s only politics, then, that stands in the way.
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