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Experts are concerned about “rapidly” rising rates of a cancer linked to one of the world’s most common sexually transmitted infections.
There has been a “steady increase” in throat (oropharyngeal) cancer in Aotearoa in recent years: with incidence rising nearly 5% annually since 2006, recent research states.
About 70% of throat cancer cases are attributed to human papillomavirus (HPV), with smoking and alcohol use other main causes.
HPV is very common – it’s estimated that, without vaccination, about 80% of sexually active adults will become infected – and is linked to cervical, penile, vulvar, vaginal, head and neck, and anal cancers.
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* HPV vaccine uptake languishing below target amid rising cancer rates
* How HPV spread through oral sex can cause cancer in men
In New Zealand, males are approximately four times more likely to be diagnosed with throat cancer, and Māori are disproportionately affected.
“A tough journey”
Five years ago, Ian Fernie had a lump on the right-hand side of his neck.
It didn’t hurt, and blood tests didn’t turn up anything unusual. But over time, it got bigger.
His GP referred him to an otorhinolaryngologist (ear, nose and throat specialist).
Supplied
In 2018, Ian Fernie developed a lump on his neck that wouldn’t go away. It turned out to be HPV-related throat cancer.
When he saw the specialist in early 2019, they “took one look at me, [and said] I’m pretty sure you’ve got cancer on your tonsil,” the Auckland man said.
Signs and symptoms of throat cancer may include a cough, vocal changes, difficulty swallowing, ear pain, a lump or sore that doesn’t heal, a sore throat and weight loss.
He said further testing confirmed he had inoperable, stage 3, HPV-related cancer.
It sparked a “tough journey” of radiotherapy and chemotherapy, and in early 2021, Fernie was “extremely grateful” to get the all-clear.
When HPV is discussed, people are increasingly aware of its cervical cancer link, “but we forget the others”, Fernie, a former sexual health nurse, said.
Fernie said HPV vaccination is “really important… [as] it’s so easy to prevent”.
While people can survive head and neck cancers, the cost to the person – psychologically, physically, and to their families – and to the health system is significant.
“We can nip that in the bud, [if we are] a little more proactive.”
Experts “greatly concerned”
Head and Neck Cancer Foundation Aotearoa chair, surgeon Dr Swee Tan, said they’re “greatly concerned” to see “rapidly rising” cases of HPV-related throat cancer.
“The tragedy is that these… are preventable.”
Te Whatu Ora
Year 8 immunisation: Protection against HPV
Thursday marks World Head and Neck Cancer Day.
HPV vaccination (Gardasil 9) has been available in Aotearoa since 2008, funded for boys and girls aged 9 to 26.
Tan encouraged parents and caregivers to get their children vaccinated against HPV, saying it is a “cancer-preventing vaccine”.
The New Zealand HPV Project says vaccination offers the best protection from HPV if given before becoming sexually active.
For people who are already sexually active, the vaccine may still be of benefit, as it will prevent you from getting new HPV infections from the strains the vaccine covers, it says.
Tan said people who may have missed the vaccine at school, or are unsure if they’ve had it, should speak to their healthcare provider.
Jericho Rock-Archer/Stuff
Head and neck surgeon Dr Swee Tan said other countries have adopted HPV vaccination as a key strategy to reduce rates of throat cancers, and Aotearoa “must follow suit”.
Tan and the Sexually Transmitted Infections Education Foundation were calling for action to increase Aotearoa’s HPV vaccination uptake.
Te Whatu Ora prevention director Matt Hannant said it is committed to boosting HPV vaccination rates, and has commissioned an independent review of the national schools-based immunisation programme to identify barriers and strengthen opportunities.
It has a target of 75% coverage for the eligible cohort: as of March 31, first dose uptake was 69.8%, and 55.8% for final dose.
Hannant said authorities consider it too early in the HPV vaccination programme to attribute any increase in HPV-related throat cancer to low vaccination rates.
The increase was more likely to be in the population for whom HPV vaccines weren’t available when they were in the eligible age range, he said.
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