Vaccinating Boys Against HPV Proves Cost-Effective

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Vaccinating adolescent boys against the human papillomavirus (HPV) may be cost-effective in the prevention of oropharyngeal cancer, according to the results of a study published in Cancer.

Using a cost-effectiveness analysis, Donna M. Graham, MB, BCh, MRCPUK, of Princess Margaret Cancer Centre in Toronto, and colleagues compared the potential costs and effectiveness of HPV vaccination of boys aged 12 years in Canada versus no vaccination.

In the United States, the HPV vaccine is recommended for both preteen girls and boys at the ages of 11 or 12. The vaccine, given as three shots, is also recommended for teen girls and women up to age 26, as well as for teen boys and men through the age of 21 who did not receive the vaccine when younger. It is also recommended for gay and bisexual men, or any men who have intercourse with other men, through the age of 26.

Using HPV-related oropharyngeal cancer rates among men in Canada, as well as healthcare costs and clinical effectiveness estimates, the authors created a statistical model of the potential costs and effectiveness of the quadrivalent HPV vaccine compared with no vaccination, using a theoretical cohort of 192,940 boys. The results of the study indicated that HPV vaccination could save 8 to 28 million Canadian dollars for this cohort over their lifetimes, assuming 50% vaccine efficacy and 50% uptake.

According to the study, factors that could impact the cost savings of HPV vaccination in boys are vaccine cost, vaccine effectiveness, costs of cancer treatment, and survival of patients with HPV-related oropharyngeal cancers.

“We believe this study is important because HPV-related oropharyngeal cancer has increased significantly in incidence, especially in developed countries,” said Graham in a statement. “It is projected that by 2020, HPV-related oropharyngeal cancer will become the most common HPV-related cancer in the US, surpassing cervical cancer.”

Policymakers in many countries such as the United States, Canada, and Australia have recommended HPV vaccination in boys; however, it remains unfunded and is excluded from national immunization programs in many countries worldwide, said study author Lillian L. Siu, MD, FRCPC, also of Princess Margaret Cancer Centre, in a statement. “We hope that results from this study would raise awareness and lead to further assessment of this important public health issue,” she said.

“Female vaccination has already been proven as a cost-effective strategy for the prevention of benign and premalignant HPV-related conditions in men and women,” wrote the authors in their discussion. “According to the findings of this preliminary analysis, HPV vaccination for boys aged 12 years may be a cost-effective strategy in relation to the prevention of oropharyngeal cancer alone, strengthening the cost effectiveness of a male vaccination program,” they concluded.