HPV or human papillomavirus is a sexually transmitted disease that can cause different cancers in different people and affects both men and women. There is currently a vaccine for HPV types 16 and 18 that is available to help protect against these two strains which are considered to be high-risk (1). If a colleague asked which strains should be covered in a new treatment I would suggest that the other high-risk HPV strains should be covered under a new treatment and these strains are: 16, 18, 31, and 45. According to Sarid and Gao, HPV strains 16, 18, 32, and 45 account for ~80% of cervical cancers (1). As such since these are the high-risk HPV strains I think they should be covered. Although there are more strains that may cause cancer as these strains cause the majority (>50%) of the cervical cancers then it should be that these strains are also covered under the new treatment. The recommended age for HPV vaccination currently is anywhere from 11-13 years in different countries all over the world and increases to upwards of 26 in certain countries as well (2). Since the current vaccination schedule suggests 11-13 years of age at initial vaccination then that should continue with new treatments as that should introduce the vaccination before the age of sexual activity may begin. This should however be based off of the population for which you are vaccinating and if needed should be given earlier should the population warrant earlier vaccination to help protect more children who may become sexually active before the vaccination is given. The new treatment of more strains of HPV covered should also be given to not only girls but young men as well even though it may not cause cancer if they are vaccinated against HPV there may be less of a chance to spread HPV to their sexual partners in their lifetime (2). It is suspected that with the introduction of HPV vaccination that it will prevent cervical cancer and may prevent other HPV-related cancers as well (1). While the cost of vaccination production goes up with the increase of strains it protects against the benefit of reducing or preventing cancers related to HPV help to reduce the burden on the population. This could also reduce the cost of health care for those who have the vaccination as it may reduce the risk of getting cancer which can lead to costly medical bills due to the different medical treatments one may need due to the cancer.
My recommendation would be that the new treatment should cover HPV strains 16, 18, 31, and 45 and should be given at the age of 11-13 in both young men and women. While this treatment may be more expensive since it is covering 4 strains and not only 2 the reduction in cancer would decrease the medical costs for the individual since they did not contract cancer because of the HPV which could become costly had they got cancer.
References:
- Sarid R., Gao S. 2011. Viruses and human cancer: from detection to causality. Cancer Lett 305(2): 218-227.
- Lee L., Garland S. 2017. Human papillomavirus vaccination: the population impact. F1000Research 866.
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