Natural history of human papillomavirus and vaccinations in men: A literature review.

Benjamin J Lieblong,Mayumi Nakagawa,Brooke E E Montgomery,L Joseph Su

doi:10.1002/hsr2.118

Benjamin J Lieblong, Mayumi Nakagawa + Show 2 more

Open Access

https://doi.org/10.1002/hsr2.118

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Abstract

Background and aimsInfection with high‐risk (HR) genotypes of the human papillomavirus (HPV) is necessary for and causative of almost all cervical cancers and their precursor condition, cervical intraepithelial neoplasia. These conditions have been sharply reduced by cervical cytology screening, and a further decrease is expected because of the recent introduction of prophylactic HPV vaccinations. While significant attention has been given to gynecologic HPV disease, men can be affected by HPV‐related cancers of the anus, penis, and oropharynx. This literature review aims to address disparities in HPV‐related disease in men, and certain HR male subpopulations, compared with women.DiscussionOverall, immunocompetent men are far less likely than women to develop anogenital HPV‐related cancers, despite harboring HR HPV infections at anogenital sites. On the other hand, men who have sex with men and men living with human immunodeficiency virus infection are at considerably higher risk of HPV‐related disease. Historic rates of prophylactic HPV vaccination in males have trailed those of females due to numerous multilevel factors, although, in recent years, this sex gap in vaccination coverage has been closing. In the absence of routine HPV screening in males, therapeutic vaccinations have emerged as a potential treatment modality for preinvasive neoplasia and are in various phases of clinical testing.ConclusionSuccessful reductions in HPV disease morbidity at the population level must acknowledge and target HPV infections in men.

Highlights

While cancer can have numerous etiologies, including environmental triggers, genetic predispositions, and carcinogenic agents, one of the more intriguing causes of cancer is infection with oncogenic microorganisms
While most cervical human papillomavirus (HPV) infections are cleared without incident, some may progress to cervical cancer, the fourth most common cancer worldwide in women.[5]
Oropharyngeal HPV infections and oropharyngeal squamous cell carcinomas (OSCCs) cases are on the rise and are predicted to overtake the number of cervical cancer cases in the coming years

Summary

| INTRODUCTION

While cancer can have numerous etiologies, including environmental triggers, genetic predispositions, and carcinogenic agents, one of the more intriguing causes of cancer is infection with oncogenic microorganisms. A 2008 study of MSW with no self‐reported lifetime history of sex (oral or anal) with men showed a prevalence of anal HPV of 24.8% These authors reported a 34.4% concordance rate between the HPV types detected at anal (anal canal and perianal region) and genital (urethra, glans penis, penile shaft, and scrotum) sites.[64]. Because of these negative side effects of excisional/ablative therapy, numerous HPV therapeutic vaccines have been developed and are at various stages of clinical and preclinical testing, reviewed in great detail elsewhere.[146] One such therapeutic HPV vaccine currently being tested in male patients is SLP‐HPV‐01, in the Therapeutic HPV‐16 Vaccination for the Treatment of Anal Dysplasia (VACCAIN‐T) study (clinicaltrials.gov identifier: NCT01923116). While most attention has been focused on the development of therapeutic vaccines that stimulate T‐cell responses, prophylactic HPV vaccines are being investigated in a therapeutic manner

| CONCLUSIONS

Findings

DISCLOSURES