Kuva: <span class="photographer">NIH / Laboratory of Tumor Virus Biology</span>
Kuva: NIH / Laboratory of Tumor Virus Biology

HPV-rokote annetaan vain tytöille, vaikka kaikki järki sanoo että pojatkin pitäisi rokottaa

Rokotusohjelmaan juuri lisätty HPV-rokote annetaan ilmaiseksi 6.-luokkalaisille tytöille ja siirtymäkauden aikana myös 7.-9.-luokkaisille. Rokotteen tavoitteena on kohdunkaulansyövän ehkäiseminen. Rokote ehkäisee tyyppien 16 ja 18 aiheuttamia syöpien vaikeita esiasteita jopa 95-prosenttisesti.

THL kuitenkin otti harha-askelen mainostaessaan papilloomavirusrokotetta kampanjalla Tyttöjen juttu. HPV on suurissa määrin myös poikien juttu. Monet, esimerkiksi viime perjantaina väitellyt Tiina Petäjä, haluaisivat myös poikien HPV-rokotteen kansalliseen rokoteohjelmaan.

On olemassa kaksi hyvää syytä rokottaa pojatkin: miesten syöpien torjunta ja laumaimmuniteetti. Laumaimmuniteetin logiikka on selkeä. Jos poikia ei rokoteta, virus jatkaa leviämistä ja infektioriski ei laske. Kansallisen rokoteohjelman päätöksenteossa merkittävin tekijä on kuitenkin kansanterveystaloudellinen vaikutus: pystytäänkö rokotteilla säästämään rahaa, kun viivan toiselle puolelle laitetaan rokotekulut ja toiselle puolelle sairaanhoidossa mahdollisesti säästyvät menot.

Papilloomavirus aiheuttaa monta muutakin tautia kuin kohdunkaulan syöpää: esimerkiksi kurkkusyöpää, kondyloomaa, penissyöpää ja peräaukon syöpää. Nähtävästi näihin syöpiin liittyy usein samat alatyypit, jotka aiheuttaa kohdunkaulan syöpääkin. Kurkkusyöpien osalta HPV:n osuus on jatkuvasti kasvussa, koska tupakointi vähenee ja suuseksin määrä on kasvussa. (Jatkaen Jani Kaaron aloittamaa suuseksikeskustelua: Suuseksi vaikuttaa olevan merkittävä seksitautien leviämistä muuttava voima. Nykyään suurin osa sukuelinten herpestartunnoista on tyyppiä 1, joka aiemmin on ollut tyypillinen suualueen herpes. Syyksi on epäilty lisääntynyttä suuseksiä.) Australiassa on arvioitu että jo 70 prosenttia kaikista kurkkusyövistä aiheutuu papilloomaviruksista. Tanskalaisten ja ruotsalaisten tutkimusten mukaan peräaukon syövistä 90 prosenttia johtuu papilloomatartunnasta.

HPV on myös miesten juttu, koska peräaukon syövän riskiryhmään kuuluvat anaaliseksiä harrastavat ihmiset: homomiehet saavat yli 20 kertaa todennäköisemmin peräaukon syövän kuin heteromiehet. Kansanterveydellisesti merkittävämpi ryhmä ovat kuitenkin anaaliseksiä harrastavat heteronaiset ja -miehet, joiden määrä on jyrkässä kasvussa. Uudet tutkimustulokset ja seksikäyttäytymisen muutokset kertovat, että HPV:n merkitys taudinaiheuttajana tulee kasvamaan. Vapautuvien seksuaalinormien ansiosta HPV:n vaikutus ei rajaudu kohdunkaulaan ja sukupuolielimille.

HPV:stä on harmillisen vähän tutkimustietoa, vaikka arviolta 80 prosenttia ihmisistä saa tartunnan elämänsä aikana. Suun alueen tartunnoista ei tiedetä, miten helposti ne tarttuvat. Emme tiedä onko suuteleminen riskitekijä. Tutkimusta ei helpota, että papilloomaviruksia tunnetaan yli 100 eri alatyyppiä. Suomessa on meneillään juuri laaja HPV-rokotetutkimus, jossa toivottavasti selviää myös rokotteen kannattavuus miehille.

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