05 Feb HPV-Related Cancers in Men: What Women Need to Know

Introduction:

As I delved deeper into the intricate world of Human Papillomavirus (HPV), I couldn’t help but emphasize the significance of women comprehending the full scope of this issue. While HPV is a common sexually transmitted infection affecting both men and women, discussions often gravitate toward its impact on women’s health. In this article, I aim to provide a comprehensive overview of HPV-related cancers in men and underscore the importance of vaccination, while outlining how women can actively participate in preventing HPV’s spread.

Understanding HPV:

Human Papillomavirus, commonly known as HPV, is one of the most widespread sexually transmitted infections worldwide. It’s important to recognize that HPV transcends gender boundaries and poses a substantial public health concern for everyone. This virus comprises numerous strains, the majority of which remain asymptomatic and cause no harm.

It’s quite surprising that nearly 40% of people between 15 and 59 years old will experience an HPV infection at some point in their lives. This suggests that in the near future, as many as 80% of sexually active adults will likely get an HPV infection at some point in their lives.

HPV and Cancer:

While the human immune system is generally adept at clearing most HPV infections, certain high-risk strains can lead to cellular changes that have the potential to culminate in cancer. As India contributed to 7% of the global cancer incidence and 24% of global HPV related cancer incidence in 2020. And the projected incidence of HPV related cancers is expected to increase to 121,302 by 2025.

For instance, more than 90% of anal cancers, and the majority of penile and mouth and throat cancers, are directly linked to HPV. And Cervical cancer is the second most prevalent cancer worldwide and is the fifth leading cause of cancer deaths in women. Approximately 470,000 new cases of cervical cancer are diagnosed yearly, with the mean age for the development of malignancy being 52 years.

Common HPV-Related Cancers in Men:

In the developing nation, the most prevalent HPV-associated cancer in men is mouth and throat cancer, and its incidence continues to rise.

According to a 2020 study published in the journal Cancer Epidemiology, Biomarkers & Prevention, the incidence of HPV-related cancers in Indian men is increasing. The study found that the incidence of HPV-related cancers in

Indian men increased from 2.9 per 100,000 in 2000 to 3.8 per 100,000 in 2015.
Among all cancers, 7.5% were HPV related cancers in which oropharyngeal cancer (63.2%) were the most common HPV related cancers in India among males

Some more HPV-related cancers in Indian men are seen is- penile cancer, anal cancer, and head and neck cancer.
Another study, published in the journal Indian Journal of Cancer in 2019, found that the prevalence of HPV infection in Indian men is high. The study found that the prevalence of HPV infection in Indian men is 26.6%. This means that nearly one in four Indian men is infected with HPV.

Number and proportion of HPV related cancers in Indian men.

• PBCR-population-based cancer registries
• HBCR-hospital-based cancer registries

Transmission:

HPV is highly transmissible through intimate contact, encompassing sexual intercourse, penile-oral sex, and the use of sexual devices. It’s worth noting that while using condoms or dental dams can reduce transmission risk, they do not provide foolproof protection against skin-to-skin contact, which can still facilitate HPV transmission.

Even risk factors for tumour development include persistent infection with high-risk viral types along with a large number of lifetime sexual partners, coinfection with human immunodeficiency virus, immunosuppression, and cigarette smoking.

Visible Symptoms:

While most men with HPV remain asymptomatic, some may develop growths or warts on various body parts, including the penis, testicles, anus, groin, thighs, mouth, and throat. Genital warts can exhibit considerable variation in size, shape, and texture. Although they typically do not cause pain, they can be aesthetically displeasing.

Cancer and HPV:

HPV, in and of itself, isn’t cancer. However, it has the capacity to induce cellular changes that may ultimately lead to cancer. The transition from HPV infection to cancer is often a gradual process, and diagnosis may not occur for years.

The Symptoms of HPV-Related Anal, Penile, and Throat Cancers:

The symptoms of HPV-related anal cancer may encompass bleeding, discharge, pain, or itching of the anus, swelling of lymph nodes in the anal or groin area, alterations in bowel habits, or changes in stool shape. Penile cancer may manifest as changes in penile tissue, painful or painless sores, and growths that may bleed. Throat cancer symptoms may include persistent sore throat, chronic coughing, difficulty breathing or swallowing, unexplained weight loss, voice changes, or the presence of lumps or growths in the neck.

Transmission Risks:

Several factors can heighten the likelihood of contracting HPV-associated cancer, including a history of multiple sexual partners, being uncircumcised, having damaged skin, and possessing a weakened immune system, such as individuals living with HIV.

Treatment:

Regrettably, there’s no cure for HPV. Nevertheless, effective disease management can alleviate symptoms and related conditions. Genital warts, a common result of HPV, can be treated with prescription medications or surgically removed. Cryotherapy, which involves freezing or burning off warts, is a widely used removal method. However, wart removal does not guarantee the prevention of virus transmission.

Prevention and diagnostics:

The cornerstone of preventing HPV-related cancers is vaccination. Three highly effective vaccines are available and recommended for both men and women. These vaccines protect against HPV types 16 and 18, which have the most substantial links to cancer.

As with most cases of cervical cancer causing by HPV are found outside of the United States and Western Europe. In the United States, the number of cases of cervical cancer has declined by over 80% in the last 50 years due to the implementation of the Pap smear as a diagnostic. While the number of cases has significantly decreased, approximately 10,000 women are diagnosed with cervical cancer and 5,000 die of this disease annually.

So, in conclusion, early diagnosis through regular screenings, effective preventive measures like HPV vaccination, and safe sexual practices are essential in the fight against HPV-related cancers, ultimately helping to reduce their prevalence and impact.

Living with HPV:

Living with HPV can be somewhat reassuring because, in many cases, the body’s natural defences clear the infection within two years without needing treatment. However, it’s not always that simple. Viruses like HPV can be tricky to deal with, and it might take several months or even years for the body to build up its defences. During this time, people can spread the virus without even knowing it, even if they don’t have any visible signs of the infection.

To make things better, we need to focus on developing effective drugs to treat existing HPV infections. This is an important task that needs more attention and research. Additionally, exploring therapeutic vaccines is a promising area that should get more support. In summary, we’ve made progress in understanding HPV, but there’s still more work to be done to tackle it and its potential health impact.

Support and Encouragement:

Empowering women to support their male partners in making informed decisions about HPV vaccination and regular check-ups is crucial to reducing the burden of HPV-related cancers in India. Sharing personal stories or those of others who have faced HPV-related cancers can heighten awareness of the importance of prevention and encourage men to overcome common barriers, such as stigma, lack of knowledge, and financial constraints.

We need to destigmatizing HPV and men’s health by promoting positive messages about masculinity and encouraging men to take care of their health. Develop targeted interventions for high-risk populations, such as men who have sex with men and transgender individuals.

By working together, I believe we can all create a more supportive environment for men to make informed decisions about their HPV health and reduce the risk of HPV-related cancers in Indian men and reduce the stigma associated with the virus.

RESOURCES:

1. https://pubmed.ncbi.nlm.nih.gov/32673076/
2. https://pubmed.ncbi.nlm.nih.gov/36405943/
3. https://aacrjournals.org/cebp/article-abstract/doi/10.1158/1055-9965.EPI-23-0547/728941/Regional-Variation-in-HPV-Knowledge-and-Awareness?redirectedFrom=fulltext
4. https://www.mayoclinic.org/diseases-conditions/hpv-infection/expert-answers/hpv/faq-20057761
5. https://pubmed.ncbi.nlm.nih.gov/31862245/
6. https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer

About Author

Ishika Ghosh is an intern with CAPED India and is currently pursuing MBA from SOIL Institute of Management.