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This summer, the much-discussed human papilloma virus (HPV) vaccine entered a new phase of utilisation across the UK. In response to a report by the Joint Committee on Vaccination and Immunisation,1 Public Health England has initiated a pilot in which 42 genitourinary medicine and HIV clinics will provide the Gardasil vaccine to men who have sex with men (MSM). This pilot is supported by the evidence: MSM have a higher incidence of HPV than heterosexual men2 and the virus is linked to around 85% of anal cancers.3 Among the general population, however, it is also important to remember the burden of anal cancer among women. Not only is there a higher incidence of anal cancer among women than among men in the UK (2.6 per 100 000 compared with 1.3 per 100 000), the last 10 years have also seen a higher rate of increase within the female population (a 46% increase, compared with almost no increase in men).4 With these figures in mind, eliminating women from the discussion around anal cancer prevention seems somewhat short sighted. Although efforts towards vaccinating teenage girls against HPV are likely to have a significant effect on future prevalence of anal cancer, there remains a subgroup of unvaccinated women who are currently at risk. This discussion becomes even more vital when looking at anal cancer on a global scale. It has long been known that women who are living with HIV are more susceptible to HPV-related …
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Contributors The overarching concepts of this article were developed collaboratively by all authors (DS, MS, AR). First draft of the manuscript was written by DS. All authors contributed to manuscript revisions.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.