Background information
Starting at 45, men often face serious health risks
by Martin Jungfer
80% of men and women have it: why HPV isn’t just a female problem
1.3.2023
Translation: Julia Graham
Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens worldwide. But there’s a vaccine. And yet, very few people know it’s just as important for young men as women to get immunised.
In some countries, human papillomavirus (HPV) is blacklisted as a public enemy. The reason being that HPV is one of the main causes of cervical cancer, and it can trigger other types of cancer (even in men).
In Austria, they’ve gone back to the drawing board. Young people – both male and female – can get a free HPV injection straight away, up until the age of 21. The reason it’s available to both genders is that young men are rarely aware of the part they play in spreading this sexually transmitted infection – and that HPV can also damage their own health.
What about Switzerland? I called gynaecologist Dr Rebecca Zachariah at the Winterthur Canton hospital to get myself up to speed on all things HPV and the associated vaccination for men and women.
HPV: what is it?
Human papillomavirus is pretty insidious. With 200 known types of the virus to date, HPV is one of the most common transmittable diseases worldwide. Most HPV infections are asymptomatic, meaning you’re not even aware you have them. They can also be harmless and clear up of their own accord. But by the same token, there are other types that can lead to intense cell changes, which can subsequently develop into precancerous stages, and if untreated, into cancer. The high-risk types (site in German) that can potentially be cancerous are HP virus 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59.
In fact, 99% of all cervical cancer diagnoses are linked with HPV, according to the German Cancer Research Center (in German). But HPV infections can also cause other types of cancers, which affect both men and women.
HPV: spread and diagnosis
Two thirds of all HPV infections are symptomless, which is why they can be passed on undetected via sexual contact. According to the Swiss Federal Office of Public Health (BAG) (site in German), 70% to 80% of all sexually active men and women contract HPV at some point in their life. The risk of infection is highest when sexual activity first starts.
The BAG estimates that in 70% of cases, HPV goes away by itself within a year and in 90% of cases within two years.
A cancer smear carried out by a gynaecologist or an HPV test can tell you if you have cervical HPV. «For over 21s, the recommendation is to go for cervical cancer screenings every three years. It involves cytolytic screening and is covered by your health insurance. According to health advice, primary HPV screening isn’t required until you’re 30. However, health insurers don’t pay for this test at the moment,» explains Dr Zachariah.
HPV also affects men
For a long time, HPV was considered – and still is in many circles – as purely a women’s issue. That’s a result of the abundantly clear correlation with the occurrence of cervical cancer. In Switzerland, approximately 250 new cases are diagnosed (site in German) every year along with 5,000 precancerous stages. However, even men can get the virus, pass it on without realising – thereby endangering their partner – or subsequently develop cancer.
«Anal carcinomas are also associated with HPV,» confirms Dr Zachariah. «Because they’re rarer than cervical cancer, they’re not discussed as much.»
In a study within the scientific journal Infectious Agents and Cancer, Australian researchers established a connection between certain types of HPV and prostate cancer. To quote the authors: «A causal role for HPVs in prostate cancer is highly likely.»
What’s more, cancer in the mouth and throat area can be associated with an HPV infection and affect men just as much as women. 90% of all genital warts can be traced back to low-risk HPV 6 and 11, according to the Swiss Medical Forum (site in German).
Unpleasant yet not dangerous, genital warts have been experiencing something of a renaissance in Switzerland ever since the 90s, with 25,000 new cases recorded each year. The good news is, this is something the HPV injection also protects you from.
HPV: the vaccination
As we’ve established, HPV affects both men and women. That’s why the Robert Koch Institute recommends the vaccination for both genders. The German Cancer Research Center (DKFZ) (site in German) reported that the vaccination protects 9 in 10 women from cervical cancer, 9 in 10 men and women from anal cancer, 6 in 10 men and women from mouth and throat cancer, 8 in 10 women from vaginal cancer, 7 in 10 women from vulva cancer and 6 in 10 men from penile cancer.
Even the World Health Organisation makes an impressive assessment of the HPV vaccine’s potential. One position paper outlined that the vaccination could prevent 60 million cases of cervical cancer and 45 million premature deaths.
Likewise, Dr Zachariah emphasised the recommendation for both genders to get vaccinated. «By doing so, men not only safeguard herd immunity when it comes to women’s health, but they also protect themselves.»
At what age should you get the HPV vaccine?
Germany’s Standing Committee on Vaccination (STIKO) recommends vaccinating young people before they’re sexually active – so from ages 9 to 14. A Robert Koch Institute fact sheet (in German) on the subject explains: «Immunisation is only successful when there’s no ongoing infection that contains the same type of HPV prior to the injection.»
That being said, it’s still worth getting vaccinated later on or even after an initial infection. That’s because immunisation protects you from a number of potentially carcinogenic types of HPV. What’s more, the injection reduces the risk of genital warts by 90%.
In Switzerland, the Federal Office of Public Health (site in German) recommends all 11- to 14-year-olds get vaccinated. But it’s still recommended as a primary vaccination for girls and supplementary for boys. However, Dr Zachariah says, «It would be advisable for the HPV vaccine to be classed as a primary immunisation for boys.»
How to protect yourself from HPV
HPV comes and goes, often without any signs. But in a lot of instances, the infection can entail dramatic health implications. Aside from the vaccine, there are other preventative measures you can use to protect you and your sexual partners.
For women, Dr Zachariah recommends getting a pap smear every three years from the age of 21. Unfortunately, condoms provide inadequate protection from HPV. The Robert Koch Institute (in German) outlines that «certain types of HPV also present on the skin in genital and anal areas, apart from on mucous membranes. That’s why HPV can still be passed on through very close body contact (even if a condom is used during sexual intercourse).» Boys and men are in a position to handle the virus most responsibly by preemptively protecting themselves and others through vaccination.
Olivia Leimpeters-Leth
Autorin von customize mediahouse
oliver.fischer@digitecgalaxus.chI'm a sucker for flowery turns of phrase and allegorical language. Clever metaphors are my Kryptonite – even if, sometimes, it's better to just get to the point. Everything I write is edited by my cat, which I reckon is more «pet humanisation» than metaphor. When I'm not at my desk, I enjoy going hiking, taking part in fireside jamming sessions, dragging my exhausted body out to do some sport and hitting the occasional party.
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