– I would have taken the vaccine if I had been offered it, says Vegard Knauserud (23) from Nord-Odal. He is studying to become a teacher for grades 5-10 in Norwegian, science and social studies at Innlandet University College in Hamar. As a teacher, he will teach students about how vaccines work. HPV is an infection boys and men can get various types of cancer in the anus, penis and throat. Knauserud did not know until recently that boys can also take the vaccine. – It’s not something I’ve thought about before. It might be because I haven’t known that much. It is disturbing, the uncertainty surrounding it, that it is something that perhaps the vaccine can help to prevent. Why haven’t I received it, where should I take it or should I take it? FOCUS ON MEN: Vegard Knauserud and Katinka Hughes are both active in the student community at Høgskolen i Innlandet in Hamar. – I think it is very nice that there is more talk about the health of men, in an area that has been more focused on women, says Hughes. Photo: Viktoria Hellem-Hansen / news – We are significantly behind, at least that’s what professor emeritus and former senior physician for the women’s clinic in Bergen, Ole-Erik Iversen thinks. – We are severely behind when we still have very many young cohorts, young boys who have not been vaccinated, says Iversen. The virus infection HPV is best known in cases where it leads to cervical cancer among women. It is spread through sexual contact, and the risk of getting an HPV virus increases if you have several partners. But one only needs one to be infected to get it. What is HPV? Human papillomavirus (HPV) is a large group of viruses consisting of around 200 different types. About 40 of these become infected through sexual contact and infect mucous membranes. It is estimated that over 70 percent of the population will acquire a genital HPV infection during their sexually active life. Many people will not notice anything, but in some the HPV infection develops into cancer or genital warts. HPV 16 and HPV 18 together cause approx. 70 percent of all cases of cervical cancer. HPV 31, 33, 45, 52 and 58 together are responsible for around 20 per cent of cervical cancer cases If you ignore cervical cancer, it is estimated that around 200 cases of HPV-related cancer occur annually, of which approx. 100 cases in men. HPV infection is also a cause of genital warts. 90 percent of all genital warts are caused by HPV genotypes 6 and 11. These genotypes do not cause cancer. In Norway, the HPV vaccine that protects against HPV 6, 11, 16 and 18 was used until 2017. The one used today protects against HPV 16 and 18. Source: NHI and the Norwegian Medicines Agency Since 2009, girls in the 7th grade have been offered about vaccine. Girls born in 1997 were offered first, and in 2016 to 2018 it was also offered to women who had not received the vaccine at primary school. For some, this was already too late: the vaccine was developed to protect against cervical cancer and the precursors to cervical cancer. But then the research showed something new. – In 2018, new documentation was assessed to the effect that boys would also receive increased individual protection against current forms of cancer, and after an overall assessment it was also recommended to vaccinate boys, says Fredrik Skår in the Institute of Public Health at the department for airborne, blood and sexual infections. Have wanted a vaccine for boys for ten years Boys born in 2006 and above have thus been offered a vaccine in the children’s vaccination programme. They are 17 years old this year. In 2020, Iversen wrote in the journal of the Norwegian Medical Association that for every year that passes, 30,000 boys and men are deprived of the opportunity to prevent cancer. He reacts to the fact that it has not yet been recommended to vaccinate boys even older than this age group. – I react strongly to that today. And I have argued for that for ten years. It is a sex-discriminatory vaccination, and I don’t think anything of it. WOMEN FIRST: Professor emeritus and former senior physician Ole-Erik Iversen has researched women’s health for 35 years. – It was probably right that this started as the main focus on cervical cancer. It was there that the knowledge first came, that cervical cancer is caused by HPV infection. Photo: Haukeland University Hospital He has been mainly responsible for the clinical trials of the three approved HPV vaccines in Norway. They only administered the first vaccine in 2000, and around 2005 boys were also tested. HPV cancer in men has increased. Iversen says that after starting to research it, it has been seen that HPV is the cause of cancer in many other places in women and men. – Cervical cancer is a disease that has decreased in number, while HPV cancer in men has risen significantly, and will continue to rise for many years. The burden of disease will, in the years to come, be greater in men than in women, says Iversen. According to Skår in FHI, cancer of the anus, penis and pharynx are the most common HPV-related cancers in men. Of those who got cancer in these places in 2017, 90, 32 and 77 per cent of the cases were HPV-related, respectively. HPV-related cancers are on the rise. According to the Norwegian Cancer Registry, there were 169 male patients in 2010, while 287 patients in 2019. Assessing vaccine for homosexuals Scores in FHI say that the disease burden is lower for men than for women and that no vaccine is therefore offered to men born before 2006. The knowledge of HPV-related cancer in men also came later than in women. In addition, there is a certain herd protection from the fact that almost all girls in the child vaccination program have been vaccinated since 2009. – There is now 90 percent coverage among women in these age groups in the child vaccination program, and then many men will get a herd protection from this. However, a larger study must be carried out to examine the overall picture. – A question has been submitted to FHI about whether an HPV vaccine should be recommended to several groups of boys outside the childhood vaccination programme, including men who have sex with men. That assessment has started, but has not been concluded from our side, he says. He explains that it requires a larger process if the Institute of Public Health is to issue a recommendation for vaccination of several cohorts of boys. Iversen thinks it’s nonsense. – Failure to vaccinate boys and men up to the age of 26 is today not factually justified discrimination, and thus prohibited by law. Skår in FHI also says that they are concerned that professional justifications are made for offers of vaccination. The ministry is awaiting FHI’s assessment. WAITING: State Secretary at the Ministry of Health and Care, Ole Henrik Krat Bjørkjolt, says they are awaiting the Norwegian Institute of Public Health’s assessment. Photo: Esten Borgos – FHI gives a professional recommendation on the basis of the assessment. The ministry is awaiting FHI’s recommendation, writes State Secretary at the Ministry of Health and Care, Ole Henrik Krat Bjørkjolt in an e-mail to news. Can go away on its own But there is no great reason to worry if you get an HPV infection, assures Skår. – Approximately 90 percent of infections with HPV will go away on their own. Studies that have looked at the natural course of HPV infection in men have shown that half of all infections resolve within six months, while 75 percent of infections resolve within 12 months. Scores indicate that this applies to both infections with high-risk HPV types and infections with low-risk types. There is also no screening program that can look for precursors to HPV-related cancer in men. – The HPV infection itself cannot be treated, and there is therefore no need to routinely test men for HPV, concludes Skår.
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– I would have taken the vaccine if it had been offered – news Innlandet – Local news, TV and radio
