Teenage boys as well as girls should be offered the vaccine that protects against the virus which causes cancers linked to oral sex, the leader of Britain's public health doctors has demanded.
Prof John Ashton, president of the Faculty of Public Health, is urging ministers to extend the offer of jabs against the HPV virus from 12- and 13-year-old schoolgirls to boys the same age to tackle the growing number of cancers it causes.
The link between oral sex, HPV and certain types of cancer, including cervical, throat and anal cancer, was highlighted in June when Michael Douglas blamed his throat cancer on oral sex.
Asked by Guardian film writer Xan Brooks if he regretted years of drinking and smoking, the actor replied: "No. Because without wanting to get too specific, this particular cancer is caused by HPV [the human papillomavirus], which actually comes about from cunnilingus." His admission received media attention worldwide.
Smoking and drinking remain the biggest risk factors for cancer, said Ashton. "But many people, particularly teenagers, don't realise the risks of unprotected oral sex. It is important we give our children and young people all the information they need so they fully understand what safe sex is and how to protect themselves by using condoms and dental dams. That's why it makes sense to give teenage boys as well as girls the HPV vaccine, which is already happening in Australia," he said.
The move would also help to protect men who have sex with men, he added. They are at risk from transmission of the HPV virus if they have unprotected sex. Cases of oral cancer have risen sharply over the last decade, from 4,400 a year in 2002 to 6,200 last year, with two-thirds occurring in men, according to Cancer Research UK. Experts have identified high-risk strains of the HPV virus as a key probable cause. Such patients are often younger and have not smoked, fuelling the suspicion that HPV caused their cancer.
The British Association of Sexual Health and HIV (BASHH), which represents specialist sexual health doctors, said young people and high-risk groups needed to be made more aware of the links between oral sex and HPV-linked cancers.
Urgent action is needed to make the vaccine available to men who have sex with men, as they are not protected by the "herd immunity" created by the high take-up of it by girls, said Dr Janet Wilson, president of BASHH.
Other organisations, such as the British Medical Association and the Terrence Higgins Trust HIV charity, also want gay men to be able to have the jab at sexual health clinics.
In July the public health minister, Anna Soubry, told MPs: "It is simply not fair on men who have sex with men that they should not have the same sort of protection as heterosexual men." There were important and powerful arguments in favour of offering the jabs, she said.
Schoolgirls aged 12 and 13 began being offered the HPV vaccine in 2008 to reduce their risk of later developing cervical cancer, as almost all cases of it are linked to HPV. Between 80% and 90% of 12- and 13-year-old girls now have the three jabs involved. The vaccine was changed for the start of the 2012-13 school year for a new version that also protects against genital warts, a common sexually transmitted infection.
The Joint Committee on Vaccination and Immunisation, which advises ministers on vaccines policy, has recently examined whether extending the jabs to men is cost-effective. But the case for doing so "is still unclear", it believes. It rejected an extension of the jabs in 2008.
"Some questions do remain about the best use of the HPV vaccine, and we are currently investigating the potential effectiveness of expanding HPV vaccination to men who have sex with men", said Dr Kate Soldan, HPV surveillance lead at Public Health England.
The Department of Health said that while research was under way into vaccinating men who have sex with men against HPV, "there are currently no plans to extend HPV vaccination to males, based on an assessment of currently available scientific evidence.
"Vaccination of boys was not recommended by the JCVI [in 2008] because once 80% coverage among girls has been achieved, there is little benefit in vaccinating boys to prevent cervical cancer in girls," said a spokesman.
