A new study has suggested that HPV prevention for men needs to be a focal point in preventing sexually transmitted diseases. Though the prevalence of HPV in men and women are the same (45 percent), for women, as they get older the HPV infection rate drops to about 22 percent. However, that is not the case for men.
Lead researcher Dr. Jasmine Han said, “We don’t know why it stays high in men while it drops in women. It’s higher than expected”. As you probably already know, there is a vaccine to prevent HPV, but it seems that not many men are taking advantage of this. As a traveling locum tenens, you will have the opportunity to spread this knowledge to your young male patients or their parents.
Human Papillomavirus (HPV): An Overview
Han and her team released the results of their National Health and Nutrition Examination Survey (NHANES) this week. What they found is that the overall genital HPV infection rate among men is 45 percent, but men also have a low HPV vaccination rate of just 11 percent. What this means is that HPV prevention for men could have a greater effect on preventing HPV transmissions and cancer in men and women than previously thought.
Human papillomavirus, or HPV, is a cancer-causing sexually transmitted infection. Though the prevalence of HPV in men is high, calling it an epidemic would be overstating the issue. In fact, about 80 percent of us will be exposed to HPV at one time or another in our lives. For about 99 percent of those people, their immune system will clear the virus in 12 to 24 months.
That being said, over the past 15 years, oral cancer caused by HPV have increased 225 percent and guess who accounts for 75 percent of those cases? Each year, over 9,000 cases of HPV-related cancers occur in men. Han and her team think that the virus may remain in men because of the virus location compared to women. In men, HPV lives in the penile glands, but in women, it near the surface of the vagina and can be shed easily.
HPV is the most commonly sexually transmitted infection in the United States. Ninety percent of genital warts cases can be attributed to HPV, but the infection is usually asymptomatic. Not only is this a concerning fact, but there actually is not a test to detect HPV in men. Most men won’t know they have HPV until 10 to 20 years later when they develop penile, anal, or oral/throat cancers. I guess Michael Douglas was right back in 2013.
HPV prevention for men starts with educating them about the dangers of the infection and the signs to look for. So if the virus is typically asymptomatic, how are you supposed to help your patients prevent it? Well, unfortunately, if HPV does show some symptoms, it will be in the form of genital warts or certain kinds of cancer.
Genital warts will appear as a small bump or group of bumps in the genital area. Tell your sexually active male patients to seek medical advice if they notice any unusual warts, lumps, growths, or sores on their penis, scrotum, anus, mouth, or throat.
Men with weak immune systems or that receive anal sex are at a higher risk to contract HPV and develop cancer or other HPV-related health issues.
Detecting HPV-caused Cancers
Make sure that your patients know the signs of cancer to look for in case they do contract HPV. They need to pay special attention to lymph nodes because HPV seems to love lymph node tissue.
They need to see you or another healthcare provider if they notice an enlarged, but painless lymph node in their neck. That is a major warning sign of cancer starting in the mouth and spreading to the throat. If they are unable to push the lymph node around, they need to see their healthcare provider immediately.
The Value of Vaccination: HPV Prevention for Men
There is no specific treatment for the HPV infection but there are treatments for some of the health issues caused by the virus, including cancers. To help your patients lower their risk of contracting or transmitting HPV, there are a couple things you can do as a physician.
HPV vaccines, like Gardasil, are safe and effective. It will help to protect against HPV-caused cancers and warts. Obviously, the best time to vaccinate someone for HPV is before they ever have sex. The Centers for Disease Prevention and Control recommends 11 to 12-year-olds get two HPV vaccine doses (it used to be given in three doses).
They also recommend using the vaccine as a method of HPV prevention for men through the ages of 26, especially if they have sex with other men. Unfortunately, most insurance plans will not cover the vaccine for guys older than 26. This magic age was chosen based on research that most guys have had multiple sexual partners by the time they are 26.
The vaccine is only effective if you haven’t already been exposed to HPV, so it is important to tell the parents of your younger male patients to get them vaccinated as soon as possible. It seems that HPV prevention for men is the key to reducing the prevalence of HPV for everyone.