Experts Debate Giving HPV Vaccine to Boys

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The threat of throat cancer is especially troubling, Bookman said, because doctors traditionally only look for these malignancies in long-time smokers and drinkers. "Head and neck exams are more associated with smoking and alcohol and less associated with HPV, although that's changing," he said.

And while girls and women typically see a gynecologist for their Pap smear to look for cervical cancer, "how many boys and men are going to go to a doctor and ask them to look at their throat? It's just not that common," Bookman said.

Debbie Saslow is director of breast and gynecological cancers at the American Cancer Society. She agreed that HPV also poses a threat to males, but she's not yet convinced that Gardasil would help protect them.

"We have been considering vaccination for boys since day one, but the problem is that there is just no data yet -- everything is holding until we get data that the vaccine actually works in boys," she said.

Gardasil's maker, Merck & Co., is largely responsible for pulling that data together. However, according to Bookman, "they took a more conservative stance when they approached the FDA for licensure, registration and vaccine recommendations -- their safety data base was stronger for girls than boys."

Saslow also is doubtful whether Gardasil -- which costs $360 per three-shot regimen -- would prove to be cost-effective if provided to boys as well, at least in terms of preventing the biggest threat, cervical cancer.

"It may be cost-effective to vaccinate boys if not that many girls get vaccinated," she said. "But if most of the female population ends up getting vaccinated, then vaccinating boys won't add very much."

But what about the vaccine's cost-effectiveness in preventing anal and throat cancers, plus genital warts, among boys? Saslow said that since Gardasil has not yet been proven to be effective in boys, or to be effective against cancers outside the cervix, those points remain up in the air. "We still have all these questions that we need to look at," she said.