NEW DELHI: Cervical cancer and human papillomavirus (HPV) were the most searched keywords on Google a few weeks back after the Indian government announced a vaccination programme against the disease in teenage girls under the national immunisation programme. HPV is a major cause of cervical cancer.
While the virus affects both men and women, historically, much of the focus has been on women due to the association between HPV and cervical cancer. However, it's important to recognise that HPV poses significant risks to men as well. A 2019 study published in the Indian Journal of Cancer found that 26.6% of Indian men have HPV, which means nearly one in four Indian men were affected.
Dr Vardarajan Senthil Kumar, chief medical oncologist, MSK India, Chennai, said HPV itself is not cancerous; however, it can lead to cellular changes that may eventually result in cancers of the penile, anal and head and neck regions, with a notable increase in cases affecting the latter among men.
“While many males infected with HPV may not exhibit symptoms, some may develop growths or warts in various areas, such as the penis, testicles, anus, groin, thighs, tongue or top of the mouth. These warts can vary in size, shape and texture, appearing as small or large, flat or raised, or cauliflower-shaped bumps. Though typically painless, they can be visually unappealing,” Dr Kumar said.
Explaining the symptoms of HPV related cancers, Vardarajan said the patients may exhibit bleeding, discharge, pain or itching of the anus, along with swelling of lymph nodes in the anal or groin area, and alterations in bowel habits.
“Similarly, penile cancer may manifest as tissue changes, sores or growths on the penis, potentially leading to bleeding. In cases of cancer in the back of the throat, symptoms may include a persistent sore throat, difficulty in swallowing or breathing, weight loss and noticeable lumps in the neck,” he added.
Dr Arun Kumar Giri, director of surgical oncology, Aakash Healthcare, Delhi, said one in three men are affected by HPV, but in nine out of 10 cases, it resolves naturally over time.
Lack of definitive testing
However, despite these symptoms, currently, there isn't a definitive test to distinguish temporary HPV infections from those with the potential to develop into cancer. While women can undergo Pap test for cervical cancer screening, no such test exists for men.
"Due to the slow progression of cancer, diagnosis often occurs years or even decades after HPV infection, as there is currently no approved test for HPV in men. Despite challenges in early detection, the chances of cure are notably high, exceeding 90%, particularly when cancer is diagnosed at an early stage and remains localised without spreading to other areas of the body," said Dr Kumar.
Vaccination is crucial
Experts said, like in women, vaccination against HPV is crucial for men to prevent cancers borne out of it.
"Vaccination can prevent HPV borne cancer in men the same way as it prevents in women. Nowadays, it is recommended for men to take the vaccine, especially young boys. World over, it is being given to young boys in order to prevent cancer in men. It is on the vaccination programme of European countries. It is still not recommended for use in men in India even though it is recommended for use in women," said Dr Rahul Manchanda, senior consultant, endoscopic gynecology, PSRI Hospital.
"Globally, an estimated 69,400 men develop HPV-related cancers annually. This underscores the critical need for vaccination and adherence to safe sexual practices among men to mitigate the impact of HPV on their health," Dr Kumar added.