Halifax doctor sees rise in HPV-caused cancers among young people

A Halifax head and neck surgeon says he has seen a significant shift in the patients with cancer in his operating room.

Instead of older Nova Scotians with smoking-related cancers, Dr. Matthew Rigby is operating more on younger people with HPV, a common viral infection that is often benign but can cause certain cancers.

"I would say half of our cases are now related to HPV and in the tonsil and tongue, whereas probably less than 10 per cent would have been 20 years ago," said Rigby, a staff surgeon at the QEII Health Sciences Centre in Halifax.

"The number of people who show up with cancers that are not related to the virus [HPV] is decreasing, but the rates of head and neck cancer is pretty stable because this virus-associated cancer is so much on the rise."

Men more likely to get certain HPV-linked cancer

HPV, or human papillomavirus, is the most common sexually transmitted infection in Canada and can easily be spread through sexual skin-to-skin contact.

Rigby said most people who have sex will get HPV at some point in their lives, but it will usually go away without any intervention. There is no cure for the virus itself, which has more than 100 strains.

Infections that persist can turn into different cancers, including cervical cancer. Rigby said HPV-related head and neck cancers are about three times more likely to occur in men than women.

"Men tend to have more persistent infections so they clear it less often and are more likely to get cancer at the back of the throat," he said. "We don't know why that is."

There are vaccines available for men and women that protect against certain types of HPV known to cause cancer. They can be administered to people as young as nine years old. The vaccines are considered most effective if they're given before a person becomes sexually active, according to the Canadian Cancer Society.

Dr. James Fawcett, a professor in the departments of pharmacology and surgery at Dalhousie University in Halifax, has researched how HPV triggers the growth of cancers in the mouth and throat.

He said there are a lot of unknowns for people who are unvaccinated.

"People who are given the vaccine will be fairly well protected, but it's the population who doesn't have it, that is the worry," he said.

"That's where the research is most important."

Vaccination program targets teens

Nova Scotia began offering three doses of the Gardasil HPV vaccine to Grade 7 girls through a publicly funded program in 2008. In 2015, it expanded the effort to offer it to boys. It is not mandatory and requires consent.

Men who have sex with men are also eligible for the publicly funded vaccine. It is available to others at a cost of about $420 for all three shots.

Leigh Heide, provincial co-ordinator for the Nova Scotia Sexual Health Network, said education and awareness are key to prevention, in addition to vaccines.

"Comprehensive sexuality education is really important in schools, and I think we have a long way to go in Nova Scotia and Canada," they said. "That's the biggest thing that will prevent the spread of STIs [sexually transmitted infections].

"People make better choices when they are informed."