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ENT Conditions and Procedures

Human papilloma virus (HPV)

Human papilloma virus (HPV) is the name for a group of more than 100 viruses that affect the skin and mucous membranes of the body.  They can be responsible for many benign lesions such as warts and verrucas, and are transmitted through intimate skin-to-skin and mucosa-to-mucosa contact. HPV can also cause cancers of the cervix, vulva, vagina, penis, or anus.

Their association with laryngeal papillomatosis, and an increasing body of evidence supporting their association with cancers of the tonsil, pharynx and larynx is particularly pertinent to ENT surgeons. Cancers in this region are increasing at a rate higher than other types of cancer, most likely because of their association with HPV.

Currently, females aged 12-18 are eligible for the HPV vaccine (Gardasil) in the UK. This covers HPV types 6, 11, 16 and 18. Types 16 and 18 are responsible for up to 72% of oropharyngeal carcinoma. The vaccine is also now being offered to the MSM (men who have sex with men) group as they are less likely to benefit from the female vaccination programme.

Boys should not be able to contract HPV from girls who have been vaccinated, but currently 15% of girls have not received the vaccine. This means that boys still have a high risk of being exposed to HPV infection and the risk of malignancy associated with it. Up until now, boys have not been part of the vaccination programme.

However, as part of a concerted effort over the last few years, ENT-UK, along with other specialist organisations, have supported HPV Action in lobbying the government to vaccinate boys.

We were delighted that as a result of this, the Joint Committee on Vaccinations and Immunisations (JCVI) advised the Department of Health and Social Care (DHSC) in July 2018 that adolescent boys should also be part of a vaccination programme. The Government has announced that this will commence in 2019, and the health ministers of Wales and Scotland have also agreed to implement this change. It brings the UK into line with around 20 other countries that already vaccinate boys or which plan to do so soon. These include Australia, Austria, Brazil, Canada, Germany, Israel, Italy, New Zealand, Norway, and the USA.

At this point, the authorities in Northern Ireland are yet to announce whether they will be following the same policy, and ENT UK will continue to assist HPV Action in lobbying them.

 


Further information can be found in the following documents:

HPV and throat cancer (information for patients, their families and loved ones)

HPV and throat cancer: talking to patients and their families (a guide for clinicians and other health professionals)