Impact of human papillomavirus vaccination on male disease - A Systematic Review

Abstract

ABSTRACT Human papillomavirus (HPV)-related diseases are prevalent in men worldwide, comprising external anogenital condyloma, anal intraepithelial neoplasia(AIN), penile intraepithelial neoplasia(PIN), anogenital and oropharyngeal cancers. There is exceptionally low coverage of the male population having reached only 4% of full-vaccinated men worldwide, by 2019. This study aims to assess the impact of HPV vaccination on male disease. Three databases (MEDLINE, Web of Science, Scopus) and Clinical Trials.gov were searched. We included thirteen studies, eight randomized controlled trials (RCTs) and five cohorts, comprising a total of 14,239 participants. Regarding anal disease, eight studies reported vaccine efficacy ranging from 91.1% to 93.1% against AIN1 and ranging from 89.6% to 91.7% against AIN 2|3 and anal cancer. Five studies showed efficacy against genital condyloma of 89.9% in HPV-naïve males and it ranged from 66.7% to 67.2% in intention-to-treat populations. Studies reporting no efficacy have included older participants. These results support vaccination, beyond HPV-naïve males, of young men previously infected. Evidence quality was moderate to low for most outcomes, namely genital diseases. RCTs are needed to assess the effect of HPV vaccination on male oropharyngeal cancer.