HPV & HIV Basics
One of the podcasts that I only sporadically listen to is called Skeptically Speaking, and is actually a real radio show (yes, they still have those) that is recorded and uploaded to iTunes as a podcast so you can listen to it even if you are out of range. It's a good show, I just didn't discover it until I was already polysaturated, so to speak, with podcasts, so I only download those episodes that have titles I am particularly interested in.
This was one such episode. It is all about HIV and AIDS, but they start the episode out with a short bit on HPV, including a description, questions-and-answers from the audience, and a discussion of the vaccines. I highly recommend you check this out:
or http://www.skepticallyspeaking.com/podcasts/Skeptically_Speaking_122_HIV_and_AIDS.mp3
I have only a quibble about the episode concerning the HPV section. In that bit, the expert talks about the cost benefit of the vaccine. Now, I don't actually have a problem with a discussion on cost-benefits. I can separate out my emotions from my ethics from the practical considerations. I believe it is the right thing, the safe thing, and the ethical thing to encourage vaccinations in men and women. But I can also see that the cost analysis of the vaccine, from both a personal decision perspective and from a governmental budgetary standpoint, might recommend that HPV vaccination is lower on the priority list than other vaccinations, or even other programs.
No, my quibble is that I think the expert left out a major factor that could affect both an individual person's and a governmental agency's decisions regarding the cost-benefit analysis. He points out that cervical cancer is almost entirely caused by HPV, and that cervical cancer is one of the most common forms of cancer in women. Therefore, it is to the benefit of both an individual and the government agencies concerned with public health issues to ensure that women get vaccinated.
But only a very small percentage of the male population get any sort of genital cancer from HPV - namely anal cancer. According to this expert (and I didn't check his facts, so I'll take it at face value for now), pretty much the only men who get anal cancer are MSM or men who have sex with men (this includes men who are not "gay", as a self-identifier). MSM is a statistically significantly small portion of the population, and of that small portion, only a small number of THEM get anal cancer.
So, from a purely cost-benefit perspective, it may not be the most efficient use of resources to make sure all men get vaccinated, and it may not be the highest priority of men who do not fit into the high risk category to spend their money on a vaccine that probably won't help them out in any way. The reason for men to get vaccinated, according to this expert, is to protect a future female partner (which is, I think, a worthy reason, but I can see why it might take a back seat due to finances).
My quibble is that this expert did not mention anything at all about oral cancers and HPV. The latest statistics (for which I don't have time to cite at the moment) now say that HPV is the leading cause of all oral cancers (mouth, tongue, throat, etc.). Not necessarily because HPV-caused oral cancers are rising (they are, but not much), but because smoking is dropping. But what that means is that now the majority of all oral cancers can be prevented by a vaccine.
It is possible that, if you add up all the numbers of oral cancers in men and women, those cancers caused by HPV, cost of the vaccine, etc., it might still be not cost-effective to encourage mass vaccination of men. I haven't added up the numbers, so that is one possible outcome. I'm disappointed that the expert didn't mention oral cancers at all. Maybe only 1% of all men in the US ever get HPV-caused anal cancer, and we can predict 99% of that 1% based on behaviour, so maybe that isn't worth it to push for mandatory male vaccination, whereas mandatory female vaccination has a much better cost-benefit analysis. But maybe enough men get HPV-caused oral cancers that the number could actually tip the balance in favor of mass male vaccination. I would have liked for him to at least mention it.
But aside for that bit, the episode is informative and fairly easy to understand, so I recommend giving it a listen.