HPV vaccination linked to lower risk for related cancers among men
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Key takeaways:
- Men vaccinated for HPV have lower risk for related cancers, specifically head and neck cancer.
- Study results reaffirm association between HPV vaccination and reduced risk for cervical cancer.
Men vaccinated for HPV less frequently developed all related cancers, particularly head and neck cancers, according to findings scheduled for presentation at ASCO Annual Meeting.
The results also reaffirmed previous data that showed women vaccinated for HPV had lower risk for cervical cancer compared with women who have not received the vaccination.
“People under 40 vaccinated for HPV appeared to have lower rates of cancers often caused by HPV,” Jefferson DeKloe, BS, medical student at Western Michigan University and research fellow at Thomas Jefferson University, said during a press briefing.
Background and methodology
In 2022, the CDC reported that less than 60% of children between 15 and 17 years old had been vaccinated for HPV, according to background information DeKloe reported in an ASCO press release.
The HPV vaccine has been approved for both men and women aged 9 to 45 years.
Prior research has focused on the association between HPV vaccination and cervical cancer, but less so on other HPV-related cancers.
DeKloe and colleagues conducted a retrospective study to investigate the risk for developing all HPV-related cancers — head and neck, anal, penis, vulva, vagina and cervix — for those who received the vaccination and those who did not.
They built their study cohort with information from the TriNetX United States Collaborative Network, which has data on 90 million patients from 63 health care organizations in the U.S.
Researchers included individuals aged between 9 and 39 years who received any vaccination between 2010 and 2023.
They separated that population into two groups — individuals who received an HPV vaccination at least 5 years before and those without HPV vaccination history.
The final study cohort consisted of 5,458,987 patients (949,249 vaccinated; 55% women; 51% white; 22% Black/African American).
Results and next steps
Men who received an HPV vaccination had lower odds of being diagnosed with any HPV-related cancer compared with those who did not get vaccinated (OR = 0.46; 95% CI, 0.29-0.72).
Reduced risk for head and neck cancers (OR = 0.44; 95% CI, 0.26-0.73) significantly impacted the overall data.
“We knew in the past that head and neck cancer was really related to smoking and alcohol and other factors, and as those rates have decreased, initially there was a decrease in the amount of oropharynx cancer; but now, the increase in the incidence of oropharyngeal cancer we’re seeing is related to the virus,” Lynn M. Schuchter, MD, FASCO, ASCO president, director of Tara Miller Melanoma Center at University of Pennsylvania, said in response to DeKloe’s presentation.
Women vaccinated for HPV had lower risk for cervical cancer (OR = 0.46; 95% CI, 0.29-0.72) and overall HPV-related cancers (OR = 0.73; 95% CI, 0.57-0.94) compared with women who did not receive a vaccine.
Women who got the vaccine also had reduced risk for high-grade squamous intraepithelial lesions (OR = 0.44; 95% CI, 0.3-0.65), carcinoma in-situ (OR = 0.42; 95% CI, 0.25-0.72), abnormal Pap findings (OR = 0.87; 95% CI, 0.79-0.95) and procedures to remove precancerous cervical lesions (OR = 0.45; 95% CI, 0.28-0.71)
Future studies could investigate individuals aged 39 and older, impact of age at vaccination, development of cancer following vaccination for those who receive it, and whether specific populations (racial/ethnic, sociodemographic) do not get vaccinated. “This study really highlights the importance of getting HPV vaccine,” Schuchter said. “The goal here is that young girls and young boys get vaccinated with the vaccine. That prevents the development of HPV infection, and then that should decrease the risk for cancer.”
References:
- ASCO. Risk reduction from HPV vaccination goes beyond cervical cancer (press release). Available at: https://society.asco.org/about-asco/press-center/news-releases/risk-reduction-hpv-vaccination-goes-beyond-cervical-cancer. Published May 23, 2024. Accessed May 23, 2024.
- DeKloe J, et al. Abstract 10507. Presented at: ASCO Annual Meeting; May 31-June 4, 2024; Chicago.
Perspective
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Monica Avila, MD, MPH
This is a retrospective database study, so the results will be largely impacted by disease prevalence and by prevalence of HPV in those specific disease sites, which reflects their results. I don’t believe researchers evaluated whether the specific cancer types were HPV-linked, ie, actually caused by HPV on pathology reports (this is just the nature of databases). Hence, you are weighing the impact of HPV vaccination or not on those with all head and neck cancers (that may or may not be HPV related).
Therefore, you do see a higher reduction of head and neck cancers in men because the prevalence is higher in men compared with women. Same for cervical cancers as expected in the population at large. What is interesting to note is that the other lower genital tract cancers like vulva and vaginal are not as impacted by HPV vaccination. Although there could be a physiologic component to this (for example, due to less viral clearance on more keratinized transition zones of the body like the vulva), this is in fact probably due to lower prevalence of HPV-driven vulva/vaginal cancers and, hence, why even though they are capturing these disease sites from the database, the cancers themselves are not due to HPV specifically and, hence, not impacted by vaccination. For example, over 90% of cervical cancers are due to HPV and, hence, why vaccination is effective, but only 40% to 50% of vulvar cancers are due to HPV.
My takeaway is for those cancers driven largely by HPV, vaccination is extremely effective. And for those cancers less driven by HPV, of course, vaccination is not effective because it doesn’t impact the disease evolution and progression. The results reflect the expected outcomes based on the nature of conducting a database-driven study.
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DeKloe J, et al. Abstract 10507. Presented at: ASCO Annual Meeting; May 31-June 4, 2024; Chicago.
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