Below you will find a list of the latest publications our work at the Anal Cancer Foundation has been featured in.


Government advisers are reconsidering their recommendation against vaccinating boys for HPV, after appearing to admit that initial cost modelling may not have been based on real-world costs.

Original article – GP Online – published 17th November

The Joint Committee for Vaccinations and Immunisations (JCVI) has postponed its final recommendation regarding whether boys should be included in the HPV vaccination programme.

It comes after the committee, which advises the government on its vaccination programmes, released an interim statement in July warning that extending the programme to boys was ‘highly unlikely to be cost effective’.

But minutes from a recent JCVI meeting suggest that the cost analyses used to determine this were calculated based on inaccurate information about vaccine pricing, which may affect the outcome.


The JCVI added that there was more than one type of HPV vaccine available, and there was ‘potential to consider’ using HPV vaccines of differing valences for girls and boys as a cost-effective approach.

Since publication of its interim statement, the JCVI said stakeholders had also raised legal questions about whether it was discriminatory not to include boys in the vaccination programme.

The committee concluded that the modelling work needed ‘final checks, peer review and additional scenarios explored’. As a result, it said it was ‘not yet in a position to finalise its recommendation on boys’ vaccination’.

The JCVI began its assessment of vaccination for boys in 2013. Campaigners have warned that five years should be ‘more than enough time for a decision’, warning that 400,000 more boys are left unvaccinated and at risk to HPV-related every year.

The scheme vaccinating teenage girls launched almost a decade ago in 2008 to help protect them against cervical cancer.


But campaigners welcomed the news that the JCVI could be looking to change its recommendation.

HPV Action campaign director Peter Baker said: ‘While we are pleased that JCVI is listening to HPV Action and looking again at its interim decision not to vaccinate boys, we are very concerned about how long this process is taking.

‘The JCVI’s review of HPV vaccination for boys began in 2013 and a decision was supposed to have been made in 2015. The announcement was then postponed to early 2017 and now we are looking at 2018.’

Tristan Almada, co-founder of the HPV & Anal Cancer Foundation, said: ‘Although the public is familiar with the HPV vaccine as the “cervical cancer jab”, HPV is responsible for the fastest increasing cancers in UK men today.

‘Recognising the HPV vaccine as our best opportunity to prevent cancer since smoking cessation, 15 countries, including the US, Canada, and Australia, are now vaccinating their boys against a virus that causes cancer in both genders. UK boys deserve the same.’


“The unprecedented progress in our understanding of the role of HPV in cancer and the development of effective and safe vaccines can decrease the HPV associated cancer burden only if vaccination rates for girls and boys improve substantially worldwide.”

Read the full article here:

Expanding the benefits of HPV vaccination to boys and men


Paulette Crowther said she had colon cancer, but she didn’t. As she fought for her life, only her children and closest family friends knew her real diagnosis: Stage IV anal cancer. “She didn’t even want to say the words anal cancer out loud, let alone talk about it. Colon cancer seemed more normal to her,” says Crowther’s daughter, Justine Almada. Crowther was diagnosed after a routine colonoscopy picked up a lesion on her anus that was later determined to be squamous cell carcinoma. Further tests showed the cancer had spread to her lymphatic system. In 2010, just two years after the initial diagnosis, she died at the age of 53.

Diagnosed in just over 8,000 people each year in the U.S., anal cancer is a rare disease, but its incidence has doubled over the past three decades and continues to rise at about 2 percent each year. Anyone can get anal cancer, but Crowther’s diagnosis was a shock since none of the typical risk factors—having multiple sex partners, having anal intercourse, being HIV-positive or having received an organ transplant—applied to her. She felt fine and had no signs or symptoms leading up to her tests. But much more than surprise, Crowther felt embarrassment. “She had a lot of shame and fear of assumptions people would make—that they would think she had done something to bring on her cancer,” says Almada.

Dr. Cathy Eng, an oncologist who specializes in treating anal cancer at the University of Texas MD Anderson Cancer Center in Houston, says Crowther’s response is common. “There’s a real stigma with anal cancer that doesn’t exist with other cancers,” she says. Attaching societal stigma to those suffering certain cancers is nothing new. Breast cancer, now celebrated loudly with all things pink, was once only spoken of in hushed tones—it was considered revolutionary in 1974 when then–first lady Betty Ford openly discussed her diagnosis and radical mastectomy. People with colorectal cancers and testicular cancers faced similar social shame, until Katie Couric made colorectal a household word after getting a colonoscopy on morning television and Lance Armstrong went public with his fight.

Anal cancer faces a “double hit” when it comes to prejudice, says Eng. “First, because it’s associated with a body part that is already taboo. And second, because it’s associated with sexual activity.” The prejudice against anal cancer, coupled with its rarity, may make those affected slower to respond to early symptoms, such as itching or bleeding.

“I thought I had a hemorrhoid. I was not exactly in a hurry to have someone check out my hemorrhoid,” says Michele Longabaugh, who was diagnosed anal cancer in 2010. Longabaugh has experienced her fair share of raised eyebrows from people when she discloses her diagnosis. “If I had breast cancer, I’d have all the support in the world. With anal cancer, you get the feeling people want you to justify your sex life for them,” she says. Almada says her mother’s fear of judgment left her feeling alone and isolated. Almada and her siblings were determined to find other patients who might understand what she was going through—but their search revealed no one.

“I thought I had a hemorrhoid. I was not exactly in a hurry to have someone check out my hemorrhoid,” says Michele Longabaugh, who was diagnosed anal cancer in 2010. Longabaugh has experienced her fair share of raised eyebrows from people when she discloses her diagnosis. “If I had breast cancer, I’d have all the support in the world. With anal cancer, you get the feeling people want you to justify your sex life for them,” she says. Almada says her mother’s fear of judgment left her feeling alone and isolated. Almada and her siblings were determined to find other patients who might understand what she was going through—but their search revealed no one.

It’s been 10 years since the introduction of the HPV vaccine, and today the Centers for Disease Control and Prevention recommends routine vaccination for both girls and boys starting at age 11 or 12. “The goal is to vaccinate kids before they have a chance of becoming sexually active to protect them from developing HPV-related cancers that occur later in life,” says Palefsky. But most parents take a pass: Only 40 percent of girls and 21 percent of boys in the U.S. are fully inoculated with the HPV vaccine. There are many reasons for low uptake, but a recent study has shown that a major factor is the pediatricians and family care doctors not strongly recommending the vaccine to parents, many of whom were uncomfortable talking about it. Doctors’ hesitancy contributes to ambivalence among parents, many of whom already have concerns about the safety of the vaccines or that it will encourage promiscuity—concerns Palefsky says have “been proved many times over to be unfounded.”

It’s been 10 years since the introduction of the HPV vaccine, and today the Centers for Disease Control and Prevention recommends routine vaccination for both girls and boys starting at age 11 or 12. “The goal is to vaccinate kids before they have a chance of becoming sexually active to protect them from developing HPV-related cancers that occur later in life,” says Palefsky. But most parents take a pass: Only 40 percent of girls and 21 percent of boys in the U.S. are fully inoculated with the HPV vaccine. There are many reasons for low uptake, but a recent study has shown that a major factor is the pediatricians and family care doctors not strongly recommending the vaccine to parents, many of whom were uncomfortable talking about it. Doctors’ hesitancy contributes to ambivalence among parents, many of whom already have concerns about the safety of the vaccines or that it will encourage promiscuity—concerns Palefsky says have “been proved many times over to be unfounded.”

There is no clear medical consensus on screening for anal cancer, but some doctors advocate screening for those who are at high risk, through an anal Pap smear. If precancerous or cancerous cells are found, Palefsky says, they can then monitored or removed at their earliest, most treatable stages. “We believe that detecting and removing HPV-damaged cells should be standard of care for the prevention of anal cancer, but we haven’t yet established the evidence for this yet. To put this in perspective, no one knew that cervical cancer was preventable before the use of Pap smears became widespread in the 1960s either,” says Palefsky.

Palefsky is lead investigator of the Anchor study, the first clinical trial to study the role of screening for anal cancer. Funded with an $89 million investment from the National Institutes of Health, the eight-year study will investigate whether screening for and treating certain HPV-related abnormalities reduces their risk of developing anal cancer. A nationwide network of 15 hospitals and clinics will enroll more than 5,000 HIV-infected men and women—a population that is 80 times more likely to develop anal cancer—into the Anchor study.

There is no clear medical consensus on screening for anal cancer, but some doctors advocate screening for those who are at high risk, through an anal Pap smear. If precancerous or cancerous cells are found, Palefsky says, they can then monitored or removed at their earliest, most treatable stages. “We believe that detecting and removing HPV-damaged cells should be standard of care for the prevention of anal cancer, but we haven’t yet established the evidence for this yet. To put this in perspective, no one knew that cervical cancer was preventable before the use of Pap smears became widespread in the 1960s either,” says Palefsky.

Palefsky is lead investigator of the Anchor study, the first clinical trial to study the role of screening for anal cancer. Funded with an $89 million investment from the National Institutes of Health, the eight-year study will investigate whether screening for and treating certain HPV-related abnormalities reduces their risk of developing anal cancer. A nationwide network of 15 hospitals and clinics will enroll more than 5,000 HIV-infected men and women—a population that is 80 times more likely to develop anal cancer—into the Anchor study.

Three months after their mother passed away, Almada and her siblings established the Anal Cancer Foundation to raise awareness of the connection between HPV and anal cancer, the importance of HPV vaccination and screening in cancer prevention, and to push for research into new anal cancer treatments. The foundation has, for example, provided grant funding to advance research into powerful new immunotherapies, which rally the body’s own immune system to find and destroy cancerous cells without damaging healthy tissue.

One such grant supported Eng’s early research into a potential treatment for anal cancer that has spread beyond the anal canal and no longer responds to standard care. Recently published results from her study show that the drug, an immunotherapy called nivolumab already approved to treat other forms of advanced cancers like Hodgkin lymphoma and non–small cell lung cancer, could work: Of the 37 patients in the trial, two had tumors that disappeared and seven had tumors that shrunk considerably. In another 17 patients, nivolumab kept tumors from growing any larger.

The trial was at capacity within months, which Eng says speaks to the “unmet need” of anal cancer patients. “We have been using the same old chemotherapy and radiation since the 1970s, says Eng. “This is a real step forward in a cancer where there have not been many steps forward.”


A letter signed by 13 HPV experts has been published today in The Times, UK, calling on the government to extend the vaccine to all boys. This followed a letter sent at the end of last week to Secretary of State for Health, Jeremy Hunt signed by these leading clinicians, academics and scientists in HPV.

A transcript of the letter is included below:

Dear Secretary of State
HPV vaccination for adolescent boys

Under the auspices of HPV Action, we are writing as clinicians, scientists and academics with a special interest in human papillomavirus and its associated diseases (anal, cervical, oral, penile, vaginal and vulval cancers, anogenital warts and recurrent respiratory papillomatosis) to urge you to expedite a decision to extend the national HPV vaccination programme to include all adolescent boys.

We are very concerned about the Joint Committee on Vaccination and Immunisation (JCVI) timescale for a decision on vaccinating boys. As you will know, its assessment of this issue began in 2013 and a decision was expected in 2015. This was then put back to 2017. If a decision is made in 2017 to vaccinate boys,implementation of the programme might well not begin until 2020.Up to 80% of sexually active men will acquire HPV at some point in their lives and,with each year that passes, some 400,000 more boys are left unprotected. Even if a vaccination programme for boys does start in 2020, over 2.5 million boys will by then have missed out on vaccination in the period since 2013. We strongly recommend that JCVI is allocated the resources necessary to enable a decision to be made in the current year.We firmly believe that vaccinating boys as well as girls would:

1. Protect more women from HPV-related diseases. Even though the UK achieves a high uptake for its vaccination programme for girls, some 10% of girls remain unprotected. Vaccination uptake is also variable and in some parts of the country, notably several London boroughs, vaccination rates in girls are far lower than the national average.


2. Protect men who have sex with men (MSM). Because MSM derive no benefit from the girls’ programmewe welcome the JCVI’s recommendation that HPV vaccination should be offered to MSM via sexual health clinics and believe this should be implemented on a national basis without delay. However, we note that the average age of first attendance at GUM clinics is 28 years and we therefore have doubts that this intervention will reach most MSM; even more importantly, it is well-established that the optimal time for vaccination is before sexual debut.Our view is that the only certain way to protect MSM adequately is to vaccinate all boys.


3. Protect men who have sex with women who have not been vaccinated in the UK or elsewhere. The NATSAL-3 study of sexual behaviour showed that many men,especially younger men, have sex with women from other countries; many of these have no or low-uptake HPV vaccination programmes. Approximately 15%of 25-34 year old males have had at least one sexual partner from outside the UK in the past five years.


4. Ensure that both men and women receive equitable protection from HPV-related diseases. The total burden of these diseases affects men and women about equally and we therefore believe that there is a strong ethical argument for the equal protection of both sexes. We recommend that you ask the JCVI to consider ethical and equality issues as part of its assessment.


5. Reduce significantly the costs of treating HPV-related diseases. We note that the cost of treating anogenital warts alone in the UK is an estimated £58.44 million a year; the secondary care costs of treating HPV-related oropharyngeal cancer are likely to exceed £21 million a year. Even though we have reservations about the
JCVI’s approach to assessing cost-effectiveness (it does not take account of social care or welfare benefit costs, for example, or the costs of morbidity and mortality to employers), we believe that it would nevertheless be cost-effective within existing published models to vaccinate boys at an achievable vaccine price.


We reject the argument that a 90% vaccination rate for girls is sufficient to protect males if there is also a programme for MSM. As stated above, many MSM will not receive protection when it is most needed before sexual debut and significant numbers of heterosexual men have sex with unvaccinated women (whether in parts of the UK where vaccination rates are lower, with UK women who are too old to have been eligible for HPV vaccination as an adolescent or with women from other countries).

We are aware that an increasing number of countries – Australia, Austria, Canada,Israel, Switzerland, the USA, the German region of Saxony and the Italian regions of Emilia-Romagna and Sicily – now recommend HPV vaccination for both sexes. The Norwegian Institute of Public Health and Ireland’s Health Service Executive have also recommended that boys be included in their national vaccination programmes. The UK has an opportunity to be part of an international effort to eradicate HPV-related diseases as well as protect its own population better.

We very much hope you will now ask the JCVI to accelerate its assessment of the vaccination of boys and draw the Committee’s attention to this letter. We look forward to receiving your response; please reply to Peter Baker, HPV Action’s Campaign Director, at the address above. Please note that this is an open letter that we are also making available to the media and directly to the public.

Yours sincerely (original copy signed by the following)
  • Mr Stephen Cannon MA,  MCh(Orth), FRCS, FRCS(Ed), Vice President, Royal College of Surgeons of England
  • Dr Elizabeth Carlin, President, British Association for Sexual Health and HIV
  • Mr Ben Challacombe BSc. MS FRCS (Urol), Consultant Urological Surgeon and Honorary Senior Lecturer Guy’s and St Thomas’ Hospitals NHS Foundation Trust and Kings College London
  • Professor Giampiero Favato, Director of the Institute for Leadership and Management in Health, Kingston University London
  • Professor Nigel Hunt BDS, MSc, PhD, FDSRCS, FDSRCPS, FDSRCSE, FHEA, FGDP(UK), DOrth, MOrth RCS, Dean, Faculty of Dental Surgery, Royal College Surgeons of England
  • Professor Sean Kehoe MD DCH FRCOG FHEA, Lawson Tait Professor Gynaecological Cancer, University of  Birmingham, Senior Research Fellow, Peters College, University of Oxford
  • Professor Mark Lawler PhD, FRCPath, Dean of Education, Faculty of Medicine, Health and Life Sciences, Chair in Translational Cancer Genomics, Centre for Cancer Research and Cell Biology, Queen’s University Belfast
  • Professor M A O Lewis PhD, BDS, FDSRCS, FDSRCPS, FDSRCSE, FRCPath, FFGDP(UK), FHEA Dean, School of Dentistry, Cardiff University and Director of the Clinical Board for Dentistry, Cardiff & Vale University Health Board
  • Professor Eilís McCaughan, Professor in Cancer Care, Institute of Nursing and Health Research, Ulster University
  • Dr John McSorley, Consultant Physician, Sexual Health & HIV Services, London North West Healthcare NHS Trust
  • Professor Tony Narula FRCS, President, ENT UK
  • Professor Crispian Scully CBE, DSc, MD, PhD, FMedSci, MDS, MRCS, BSc, FDSRCS, FDSRCPS, FFDRCSI, FDSRCSE, FRCPath,  FHEA, FUCL, DChD, DMed(HC), Dhc Emeritus Professor, University College London
  • Professor Saman Warnakulasuriya OBE BDS, FDSRCS, Dip Oral Med, PhD, DSc Emeritus Professor of Oral Medicine and Experimental Pathology, King’s College London, Director, WHO Collaborating Center on Oral Cancer

Find out more about our grantee, HPV Action and HPV vaccination for adolescent boys.

The Guardian

Human papillomavirus (HPV) prevalence is down 64% since the Centers for Disease Control and Prevention (CDC) recommended a vaccination for the sexually transmitted infection a decade ago, according to a study released on Monday.

Read the full article on The Guardian website here


Jason Lupatkin said the thousands of hours he’s spent rowing in sculls, including as a former captain of the Stanford University crew team, haven’t prepared him for his latest boating adventure.

The 24-year-old Thiel Macro LLC commodities trader is part of a group of nine men — mostly financial professionals — who are rowing the 200 miles(320 kilometers) from Barcelona to the island of Ibiza to raise money and awareness for human papillomavirus, or HPV, prevention.

Participants in two 24-foot boats will race across the Mediterranean Sea, trading time at the oars with turns cooking dehydrated food and taking power naps in tiny cabins at the stern and bow. The crossing begins Monday, weather permitting, and is expected to take between 72 and 96 hours.

“I wish I could say I know how I’m going to feel, but I don’t,” Lupatkin said. “The thing is with rowing, you just have to keep going, do whatever it takes to push back that breakage point.”

The rowers have a target to raise at least $300,000 for the HPV and Anal Cancer Foundation. The charity was co-founded by Tristan Almada and his sisters, Justine and Camille, after their mother Paulette died from HPV-related anal cancer in 2010.

HPV is linked to 5 percent of cancers, including anal, penile, cervical and vaginal, which Almada said have stigmatized those infected and slowed fundraising. The virus can be prevented with a vaccine.

“We can literally eliminate this problem overnight,” Almada, 30, said in a telephone interview. “It’s hard to find such low-hanging fruit when you’re talking about preventing cancer.”

John Donne

Alongside the charity the Almadas started the NOMAN Campaign— named after John Donne’s poem “No Man is an Island” — which has raised almost $2 million in the past three years through endurance challenges. There have been NOMAN cycling teams at stage races in Europe and the group has organized a few rowing trips, including one from California to Hawaii.

Tim Glynn and Conor Murphy, Irish traders in the London office of Goldman Sachs Group Inc., did most of their training on stationary rowing machines together in the company’s basement gym before and after work. A former rugby player, Glynn had never rowed in open water when he joined the NOMAN group; Murphy, once a semi-professional gaelic football player, estimates the longest he’d ever gone on stationary rowing machine was one kilometer (0.6 mile).

Regardless of rowing experience — be it four career miles or a four-year career at Stanford — participants agree there’s no training for what they’ll encounter this week.

“There are obstacles in the water, like tide, current, navigation and wind,” Glynn, 26, said. “It’s not as straightforward as pure willpower.”

The boats have two rowing seats, so both teams will split the duties, following a two hours on, two hours off schedule. NOMAN, which is tracking the race on its website, estimates team members will burn around 25,000 calories during the crossing.

Tristan Alamada did the same row two years ago with a NOMAN boat and said mood swings were their biggest obstacle.

“The first day the sunset is beautiful, music is playing and everyone is saying, ‘Tristan, thank you so much for this adventure, I really appreciate you asking me, of all the people,”’ he recalled. “Then 24 hours later, it’s ‘Tristan this is the worst idea, please get me off this boat.’”

Unexpected Concerns

Most of the rowers’ concerns stem from the unexpected, be it blisters and saddle sores, seasickness or navigating ocean currents. There’s also the difficulty of sleeping in the boat’s cramped cabins.

“I’m hoping we get to a point where we’re so tired that we just fall asleep immediately,” said Oivind Lorentzen, a member of Morgan Stanley’s capital markets group and another former Stanford crew captain.

Fundraising, much of which has occurred in banks and hedge funds in New York, London and San Francisco, has been helped by the novelty of the race. Rowers said the response from colleagues has been overwhelming, and some, like Murphy and Glynn at Goldman Sachs, are doubly benefiting from employer donation matching.

Lupatkin, a New York City native whose parents are both doctors, said he was attracted to the race in part because of the ties to HPV prevention. In 2010 he biked from Palo Alto, California, to Boston to raise money for AIDS.

“When you grow up hearing about how your parents are helping people, it makes you feel a little silly sitting at a desk all day trading commodities,” he said. “It feeds the desire to have a social impact.”

All nine rowers have taken classes to prepare themselves for sea survival, first aid and ocean navigation. The row is supported by online currency specialist FairFX and organizer New Ocean Wave, which will operate a nearby support boat should an emergency arise.

If the teams succeed, they’ll come ashore in front of friends and family on an island well known for its nightlife. It’s also one rower’s 30th birthday during the race, so there will be plenty of reasons to celebrate in Ibiza.

“I’d imagine the first night we’ll just want to sleep,” Murphy said. “But the weekend should be fun.”


While some like to spend their holidays on a beach, cocktail in hand, London’s traders and analysts clearly like adventure. So it is that teams from Goldman Sachs, Morgan Stanley and Moore Capital are set to row across the Med next month.

Saddle sores, aches, bruises and blisters in unfortunate places await them, as they row for up to 96 hours without a break.

The race, which will see bankers, brokers, traders and analysts burning around 25,000 calories on their trip along the coast of Spain from Barcelona to Ibiza, will raise awareness of the NOMAN campaign and their work with cancer sufferers.

NOMAN raises awareness of Human Papillomavirus (HPV) and its links to cancer diagnoses. Racers will be raising funds for the Anal Cancer Foundation.

Jason Lupatkin, trader at Thiel Macro said it will be a challenge of “head-to-head mental and physical strength…trying to navigate the weathering sea and stave off sickness!” Good luck…


STANFORD, Calif. – Former Stanford men’s rowing captains Jason Lupatkin ’13 and Oivind Lorentzen ’13 have been training for the NOMAN – Row to end HPV race.

Starting on July 13, the two former Cardinal rowers will be in a boat of four for a three-day race covering approximately 200 miles on the Mediterranean from Barcelona to Ibiza.

“It will be a three-day challenge of head-to-head mental and physical strength as we will take shifts rowing and sleeping, while navigating the weathering sea,” said Lupatkin.

Since 2013, the NOMAN has raised over $1.4 million for the cause. HPV is a casual agent of five percent of all cancers.

“I have had many people affected by one form of cancer or another and the NOMAN Race will enable me to take my passion for rowing, the sea and extreme endurance challenges and push myself for outside my comfort zone to support this cause,” said Lorentzen.

Positively Aware

Positively Aware

One recent morning, a group of men and women sat in a clinic reception room, waiting for their Pap smear appointments.

You read that correctly. The Pap smear — a screening test for cervical cancer and longtime fixture of the women’s health exam — is now used to detect and prevent cancer of the anus in both men and women. Experts believe that routine Pap testing could play an important role in curbing a doubling of new anal cancer cases that have occurred over the past three decades.


While anal Paps are not indicated for most people, there is an increasing consensus that routine screening is important for people at high risk, specifically people whose immune systems are weakened due to HIV infection or medications taken after an organ transplant; men who have sex with men; and women who have cancerous or precancerous abnormalities on their cervical Pap smear.

Yet screening for anal cancer is unavailable in many parts of the U.S., and many people at high risk are unaware it exists.

“The awareness is remarkably low,” said Dr. Joel Palefsky, an infectious disease specialist and professor of medicine at the University of California, San Francisco. “Even in San Francisco it’s limited, though we have been doing [screening] a long time. The awareness is even lower elsewhere.”

Unlike colon and rectal cancer, most anal cancers are caused by a handful of strains of human papilloma virus, or HPV, a common virus (estimated to infect the majority of people in the U.S.) that has hundreds of different subtypes. Cervical cancer is caused by the same HPV strains. Most people clear HPV infections over time. But some are vulnerable to long-term infections that can eventually transform affected cells into invasive cancer.

More than 7,000 new cases of anal cancer are diagnosed in the U.S. each year, and about 1,000 individuals die of the disease annually. Even though a majority of those diagnosed — about two out of three — survive for five years or more, the disease and its treatment can be debilitating. Those who survive may have long-term problems with urination, defecation, and sexual relations. Contributing to the increase in anal cancer are the HIV epidemic and the longer lifespan of people with HIV due to highly active antiretroviral therapy, or HAAR T; an increase in the number of people with organ transplants may also have contributed.

One study of men with HIV found that anal cancer tended to be diagnosed about 13 years after they were found to be infected with HIV. Among men who have sex with men, anal cancer is now as common as cervical cancer was among women before the Pap smear was developed.

“All you’ve got to do is see one young guy with anal cancer” to realize the value of screening, said Dr. Elie Schochet, a colorectal surgeon in Fort Lauderdale. “I’ve had patients come to me with cancer and when I look back through the record, there was an opportunity to take care of this sooner.”


Compared to screening for other cancers, screening for anal cancer is a relatively new phenomenon. Many primary care doctors are unaware of anal cancer screening, and don’t routinely ask patients about whether they engage in anal sex, have a history of sexually transmitted infections, or are experiencing anal discomfort. Many doctors don’t even feel comfortable performing rectal exams. (Even though a doctor’s rectal exam may miss very early disease, some experts believe it is better than nothing in people at risk). Patients may not feel comfortable telling their doctor about their sex practices. Women with a history of cervical Pap smear abnormalities may not realize that they are at risk even if they haven’t had anal intercourse, since the virus can spread between the genitals and the anus.

“A huge challenge for us is the stigma that surrounds (anal cancer) and that part of the body,” said Justine Almada, who co-founded the Anal Cancer Foundation with her brother and sister after her mother, who had been treated years earlier for precancerous cervical changes, died of anal cancer at age 53. “It’s something easily transmissible. You don’t need to have anal sex to have anal cancer.”


Even if a primary care physician wants to perform an anal Pap on a patient, he or she is placed in a conundrum. If the screening Pap is abnormal, then the next step in the work-up for cancer or pre-cancer is a procedure called a high-resolution anoscopy. But in many parts of the U.S., specialists trained to perform this procedure are scarce or non-existent.

“It’s an ethical dilemma for doctors if they diagnose” an abnormality and can’t send a patient for anoscopy, said Jeff Taylor, 52, an HIV treatment educator and community member of the National Cancer Institute (NCI)’s AIDS Malignancy Consortium. “There’s a lot of frustration because access to [anoscopy] is so sporadic.”

Mark Hubbard, who was diagnosed with HIV 27 years ago, learned about anal Pap smears in the late 1990’s through his work as a health educator and advocate. He was concerned that he was at increased risk of anal cancer because of his HIV and because he had experienced outbreaks of anal warts, which are caused by different strains of HPV. Until recently, however, he was unable to find anyone in his home state of Tennessee who performed anal cancer screening, and had to travel to Pittsburgh — at a cost of about $500 per trip — to be tested.

“A lot of providers were completely clueless and would say crazy things,” he said. “Once I decided I really wanted to be screened, I couldn’t find anybody.”

As with the cervical Pap test, the anal Pap is simple and inexpensive. It involves swabbing the anus with a Dacron swab and then placing the swab in a liquid-filled jar that is the same type used for Pap smear samples. High resolution anoscopy — the next step if an anal Pap is abnormal — isn’t complex either, but it requires specialized training for the doctor or nurse. It uses a special microscope that is already widely available in many gynecologists’ offices, where it is used for colposcopy, the standard procedure to examine the cervix after an abnormal Pap smear.


Early last year, I spent a morning watching Dr. J. Michael Berry, a cancer specialist at the University of California, San Francisco, coach a gynecologist and an HIV specialist on how to perform anal Paps and highresolution anoscopy. The first patient was a middle-aged taxi driver who had recently had a normal colonoscopy. As the patient lay on his side on an exam table, the HIV specialist placed the tip of the scope in his anus and then looked through a connected set of magnifying binoculars, swabbing with an acetic acid-soaked cotton swab and searching for irregular areas. (The rest of us watched on a computer screen that showed what she was viewing.) The affected area turned pale. She took a small sample of the area and then rubbed it with a swab soaked in trichloracetic acid to destroy the abnormal tissue. After 20 minutes, she had finished her examination.

“To be good at this procedure, you have to do it a lot,” Berry said. “It’s very gentle — most people barely notice.”

The patient wondered why the abnormalities hadn’t been spotted on his colonoscopy. Berry explained that even though the colonoscope passes through the anus, the purpose of colonoscopy procedures is to examine the large intestine and rectum for cancer. Most colonoscopies don’t carefully examine the anus; for them to do so, the colonoscope would have to be turned backward in an unusual position. “Colonoscopy can be misleading,” Berry said. “People end up with a false sense of security — they say, ‘someone examined my butt and it was fine, so why do you want to look again?'”


Awareness of anal Pap screening has been growing among health workers. Palefsky estimates that he, Berry, and other HPV specialists have trained more than 500 health workers in high-resolution anoscopy. The International Anal Neoplasia Society, the world’s first professional group focused on preventing and treating anal cancer, held its inaugural meeting last year. The New York State Department of Health now recommends that HIV-infected men who have sex with men, as well as anyone with a history of anal or genital warts and women with a history of pre-cancerous Pap smear findings, undergo anal Pap testing each year.

“When we first started, it was like, ‘I’ve never seen anal cancer, what kind of nonsense are you talking about?'” Dr. Stephen Goldstone, a New York-based surgeon, said. “But we’re developing a critical mass. As the scientific body of evidence has grown, people have started to take notice.”

An 8-year, $89 million National Cancer Institute-funded study is now examining whether treating the precancerous anal abnormalities caused by HPV reduces anal cancer in people with HIV. The study plans to enroll more than 5,000 people in 15 sites around the U.S. Scientists hope the study will improve their understanding of the molecular changes that occur as anal cancer develops, help them ascertain whether some biomarkers, or laboratory findings, predict who is at highest risk of developing anal cancer, and find new treatments.


Perhaps most important, the study will provide the “gold standard” clinical trial evidence that the U.S. Preventive Services Task Force and U.S. Centers for Disease Control require in order to decide whether to recommend cancer screening tests. These recommendations significantly sway whether doctors perform the test and influence insurance companies that are considering whether they will pay for the test (at present, many companies will pay for treatment of an anal abnormality but not for screening to look for that abnormality). While it may seem intuitive that early treatment of precancerous anal lesions reduces a person’s likelihood of developing cancer, proof is needed that the benefits of such therapy outweigh the harms, when performed on a massive scale.

The need for such a large study is frustrating for some advocates, who point out that the cervical Pap smear, which has been credited with saving millions of women’s lives, was introduced into routine practice without such rigorous, population-based evidence. But Hubbard said he hopes the study’s findings will lead to the widespread use of guideline-based, standardized treatments.

“Cervical dysplasia was treated for years without that evidence,” he said, but added, “people tend to overtreat when they don’t know what they’re doing. There are a lot of horror stories in the community about bad treatment. This is a really important study.”

Erin N. Marcus, M.D., M.P.H., F.A.C.P., is a general internist at the University of Miami Miller School of Medicine and writes about public health. The reporting of this article was supported by a grant from the Ford Foundation.



Paulette Crowther, a former Montclair resident and Montclair Kimberley School alumna, was an inspiration to many. In 2010, after passing away following a 2-year battle with Stage IV HPV-related anal cancer, her children Justine, Tristan and Camille, all in their 20s, created the Anal Cancer Foundation.

On Saturday, January 31, the Foundation invites the community to a recruitment event at3Sixty Cycling Studio and Groove Indoor Rowing in Montclair. Attendees can enjoy either a free spin (2 pm) or rowing (3 pm) class courtesy of the studio and learn about the upcoming NOMAN 2015 eventsReserve your spot here

The Foundation focuses on raising awareness about HPV-related cancers and ensuring HPV vaccination, which can prevent these cancers, is available to all. They achieved the latter with the US government extending the HPV vaccination program to all boys as well as girls in 2011. HPV is hugely stigmatized and is responsible for cervical, anal, penile, vulvar, vaginal and oral cancers in men and women, as well as recurrent respiratory papillomatosis. Worldwide, the virus accounts for 5% of all cancer.

The Foundation created the NOMAN is an Island: Race to End HPV and Prevent 5% of Cancers Campaign, which undertakes epic endurance events to raise awareness of HPV and fund important research on HPV-related cancers. To date NOMAN athletes have broken the world record for the youngest crew to cross the Pacific Ocean, rowed from Barcelona to Ibiza and cycled dizzying heights in the Italian Dolomites raising over 1 million dollars in donations.

“We lost our mom to cancer caused by a terrible virus and we are determined to ensure it doesn’t happen to other families in the future,” says Foundation executive director and co-founder, Justine Almada. “We are so pleased to partner with 3Sixty Cycling Studio and Groove Indoor Rowing on the effort to end cancer though athletic events. Our athletic events in the past have allowed us to fund cutting edge research, patient programs and raise awareness about our ability to end 5% of cancer. HPV causes six different cancers and we have the tools to end it.”

Mark Cohen of 3Sixty Cycling Studio and Groove Indoor Rowing says, “3Sixty & Groove is not just a local business but we like to consider ourselves a community business. It’s part of our mission statement to serve the community, so paramount to that concept, fundraisers are a large part of how we accomplish that. Since our inception in 2008 we have raised over $500,000. We are extremely proud of that figure. When approached by the NOMAN campaign, we were looking for something a little different. And quite frankly I felt that due to the specifics of this campaign they needed our help. We have a strong local connection with one of the participants and it’s a great fit for what we offer at our studio. We look forward to having our facility participate in such an important cause.”

There will be no cost to attend the event at the studio. Instead, participants will choose between a free cycling or rowing class that will allow participants to have a glimpse into the physical strength required to be a NOMAN and will have the opportunity to hear more about the NOMAN Campaign to end 5% of cancer.

The Foundation is recruiting participants for multiple events in 2015. Both men and women are encouraged to participate. There will be one rowing event and three cycling events that occur between April and August 2015. All events will occur in Europe. Check the website for more details.


The Montclair Times
January 26, 2015.

Montclairites past and present are literally racing to raise awareness for anal cancer and other HPV-related cancers.

On Saturday, Jan. 31, The Anal Cancer Foundation and NOMAN Is An Island Race to End HPV will host a recruitment and awareness event at 3Sixty Cycling Studio located at 4 Lackawanna Plaza. There, attendees will be given the option of a free 2 p.m. spin class or 3 p.m. rowing class, all while learning about ways to help the cause. Signup is available at

The Anal Cancer Foundation was founded in 2010, shortly after the death of former Montclairite and Montclair Kimberley Academy alumna Paulette Crowther at the age of 53, according to Crowther’s eldest daughter, Justine Almada.

Almada, who co-founded the foundation with her siblings and serves as executive director, told The Montclair Times that during her mother’s two-year battle against anal cancer there were limited emotional support and treatment options. The foundation was created, Almada said, in an effort to avoid others inflicted with the disease from suffering a similarly isolating fate.

“It was incredibly difficult and frustrating for us to watch the person we love more than anyone else in the world go through a very difficult and painful diagnosis,” Almada said. “She was incredibly strong. She didn’t complain once. The treatments are outdated and they are difficult. Then there was the fact that we had a lot of difficulty finding somebody for her to talk to.”

Awareness for HPV-related cancers – anal, cervical, vulvar, vaginal, penile and oral – are not on the forefront of public consciousness, in part, because the connection between the cancers and HPV, or human papillomavirus, have only been made in the past several decades, Almada said. Another aspect is the fact that HPV is a sexually transmitted disease, albeit a common one. Citing Centers for Disease Control statistics, Almada said that 79 million Americans have the virus and that the majority of the population will encounter it.

HPV and related cancers are preventable through screening and vaccination, noted Almada.

NOMAN is an offshoot of the foundation and the brainchild of Almada’s brother, Tristan, Almada said. As a means of raising the profile of HPV-related cancers, NOMAN has, since 2013, organized team-oriented cycling and rowing events capable of keeping even the most well-conditioned athletes’ hearts racing. This year’s calendar includes a week-long row from Barcelona to Ibiza, Spain across the Balearic Sea and a triage of three- and four-day cycling tours through Belgium, Italy and France.

The focus on team-oriented feats ties in with the NOMAN philosophy, Almada said, in which togetherness from men and women alike are needed to help eradicate HPV-related cancers.

A team member is Kassandra Samman, formerly of Montclair, who serves as the foundation’s director of patient services and external relations. Samman, like Almada, saw her mother battle anal cancer, having first been diagnosed on Christmas Day 2011 at HackensackUMC Mountainside.

Samman told The Times that treatment for the disease is very rough, with her mother requiring 24-hour care for the first three months following her diagnosis. After six weeks of pelvic radiation, chemotherapy and subsequent treatment, Samman said that her mother was eventually able to rebound. About a year later, after her mother was well, Samman said that she reached out to the foundation asking for a way to help.

She’s been there ever since.

“I could not ask for a more fulfilling way to spend my days than working at the foundation,” Samman said.

A local partner

Next Saturday’s event will be the foundation’s first of its kind in the tri-state area, according to Almada. In holding such an event, Almada said that she sought a community-minded studio operator as a partner and found one with 3sixty Cycling Studio owner Mark Cohen.

Cohen said that he was drawn to the event both for its local component and that, given the nature of the disease, he imagined that some people may feel awkward raising money in support of fighting the disease. It’s a void he felt his studio could help fill. As the father of teenage sons, Cohen said that HPV prevention is important.

“It all made sense,” Cohen said. “It’s a different type of fundraiser in that we are very familiar with spin-a-thons and row-a-thons. This was a great way to try something different.”


Campaigners today called for school-boys to be given a £45 vaccine against an ‘entirely preventable’ sexually transmitted disease that can cause cancer.

NOMAN: Race to End HPV in the News 2014

A round up of NOMAN’s coverage in 2014 including Metro and the Mail Online.

The Anal Cancer Foundation in the News 2014

HPVACF’s coverage in 2014, the highlight of which was extensive coverage on World Cancer Day, 4th February.


BBC News

There is no national HPV vaccination programme for boys.

Scientific experts are meeting on Monday to discuss whether boys as well as girls should be offered the HPV jab. It comes amid pressure to extend vaccination to all adolescent boys in the UK, in line with other countries. The committee is expected to focus initially on whether to offer the vaccine to men who have sex with men, who may be at higher risk.

But a coalition of health experts and campaigners say vaccinating all boys aged 12 to 13 would save lives.

Since introducing the HPV vaccination for girls in 2008, we have seen incredible uptake and sharp declines in HPV infection rates but we must ensure that boys… can also reap these benefits

Shirley Cramer, Royal Society for Public Health

HPV (human papillomavirus) infections cause 5% of all cancers worldwide, and rates are rising. The virus causes most cases of cervical cancer, and some cancers in other parts of the body, including the throat, anus and penis.The UK’s HPV vaccination programme reaches over 80% of girls, but coverage rates are lower in some communities.

Peter Baker, Campaign Director of, said it was blatantly unfair that women were protected from cancers and other diseases caused by HPV infection while men were not. “Men will continue to die from HPV-related diseases unless the government acts to extend the national vaccination programme to all adolescent boys,” he said. “This would only cost about £20-£22m a year and, in the long run, save the money spent by the NHS on treatment as well as reducing human suffering.”If parents knew that their sons as well as their daughters could be protected from the virus that causes 5% of all cancers, then I’m sure most would also agree.”


The Royal Society for Public Health is among a number of health bodies calling for all boys aged 12 to 13 to be offered the vaccine. It is thought that vaccinating girls will reduce the number of men getting HPV because infection occurs through sexual contact.

But Shirley Cramer, chief executive of the Royal Society for Public Health, said vaccinating all boys would help to protect girls from cancer, as well as protecting men who have sex with men. “Since introducing the HPV vaccination for girls in 2008, we have seen incredible uptake and sharp declines in HPV infection rates but we must ensure that boys, who don’t profit from herd immunity can also reap these benefits,” she said.

“Herd immunity only works in later life for males who are sexually active with females who have been vaccinated – it won’t work for men who are sexually active in countries where the vaccine isn’t available, those who have sex with men, or those who have sex with the estimated 15% of girls who haven’t had the vaccine.”

Earlier this month, a group of MPs called for all adolescent boys to be offered the vaccine. They said more than 2,000 cases of cancer in men each year in the UK were caused by HPV. “The long-term savings in treatment and care of men with HPV-related diseases would considerably outweigh the extra cost (about £20 million a year) of extending the programme,” they wrote in a letter to the Times.

It was signed by the heads of the All-Party Parliamentary Groups on Cancer, Dentistry, Sexual and Reproductive Health, Men’s Health and HIV and Aids.


Vaccination programmes offering protection for girls against HPV have been introduced in many countries. Some countries – including Australia, the US, Austria and part of Canada – have also extended the jab to boys. Monday’s meeting involves HPV experts from the government’s Joint Committee on Vaccination and Immunisation.

Their task is to investigate whether to extend the vaccine to boys, or men who have sex with men, or both. Any decision made will be passed to the main committee for consideration in October. Public Health England said the UK HPV programme had achieved very high coverage for girls.

“Extending vaccinating to boys in the UK, therefore, is likely to provide relatively few additional benefits, and under current assessment conditions and costs may not be the best use of health care resources,” said Dr Kate Soldan, head of HPV surveillance at the health body.

“Some males, particularly men who have sex with men, are likely to gain far less protection from HPV through herd immunity from the vaccination of females.” Further studies were under way to inform the potential design and implementation of a vaccination policy targeted at men who have sex with men, she added.

  • There are more than 100 different types of human papillomavirus (HPV)
  • A number of HPV types are passed on from one person to another through sexual contact
  • Some types of HPV can increase the risk of developing cervical cancer
  • Around 3,100 women are diagnosed with this type of cancer every year in the UK.



The Mirror

As Farrah Fawcett appeared on her TV screen, Jill De Nardo shook her head in sad disbelief.

As a teenager she’d been enthralled by the actress in the TV show Charlie’s Angels. Now she was watching a documentary charting the Hollywood star’s harrowing battle with the rare cancer that killed her in June 2009.

“When I heard the words ‘anal cancer’ my instant thought was ‘she must have had a really kinky sex life to get that’,” Jill admits.

But just 12 months later, the mum-of-three, then aged 51, received the same devastating diagnosis.

Jill had lived a quiet life in Buxton, Derbyshire, married to Tony, now 59, bringing up their children, Will, Ellie and Joe, then aged 21, 19 and 17, and working as a civil servant.

Conscious of the taboo associated with anal cancer, Jill kept the diagnosis secret from all but her closest family.

But she says Ellie made her face reality when she said: “People need to know about this. Everybody has a bottom. Anyone can get this cancer.”

Although anal cancer is still relatively rare, Cancer Research UK says cases have quadrupled since the mid 1970s with figures dramatically higher for women – 1.8 per 100,000 compared to 1.2 per 100,000 males.

Around 1,200 people a year are diagnosed, with approximately six deaths a week – and there’s been a quadrupling of cases since the 70s.

In August 2009, Jill first noticed bleeding from her back passage after going to the toilet. “I’ve always been very ‘bowel aware’,” she explains. “We have a family history of bowel cancer so I’m on a screening programme and am vigilant about any changes.”

Since having children, Jill, 55, had suffered from occasional haemorrhoids – swollen veins in the anus. “But this was different,” she says. “The bleeding was heavier and there was no discomfort or obvious swellings.”

Jill’s GP shared her concerns, admitting she could “feel something” during an examination. Jill had a sigmoidoscopy – an examination of the rectum and lower bowel – at Stepping Hill Hospital in Stockport, Gtr Manchester, where “everything was fine.”

Six weeks later, as part of her routine bowel screening programme, Jill underwent a colonoscopy – where a camera is inserted into the upper bowel to detect any changes. Again, the results came back clear.

However, the bleeding continued. “After six months, my sister Penny warned that I might become anaemic and should have the piles treated,” she says.

But because of the previous all-clear Jill’s appointment wasn’t fast-tracked. It was May before a consultant took a biopsy.

“Deep down I must have suspected something was wrong as I took Tony with me to get the results,” she explains.

The consultant revealed that Jill’s haemorrhoid was, in fact, stage two anal cancer. “I’ve still no idea how it was missed in the two previous examinations,” she says. “The only possible explanation is that clinicians were so focused on my bowel that they overlooked the anal area.”

Jill was referred to Manchester’s specialist cancer treatment centre, The Christie, for six weeks of combined chemotherapy and radiotherapy.

“The radiotherapy was intense over the genital area – so I experienced quite a bit of burning and blistering,” says Jill. “But no matter how sore I felt I made a point of wearing lipstick, bangles and bright colours every day to make myself feel better.”

Thankfully, the discomfort was short-lived and the treatment was successful – with Jill now undergoing regular checks. “It was only afterwards that I realised how silly it was to be so secretive about anal cancer. The more I learned, the more I realised Ellie was right – I did need to be more open.”

Nine out of 10 cases of anal cancer are caused by human papilloma – an increasingly prevalent virus. Experts say 80% of sexually active adults are exposed to it at some point and a third of the population carry it.

“Most will live long, healthy lives,” says Jill. “But a tiny percentage will develop a cancer linked to the virus. Anal cancer is one. Others are cervical, vulval, penile, head, neck and throat.

“Many people assume – as I did – that anal cancer only affects those who have been promiscuous or had unprotected or anal sex. But it can affect anyone who has been sexually active.”

With Jill’s encouragement, Ellie launched the Behind Cancer Campaign. Then they were approached by The Anal Cancer Foundation to join forces.

“One of the key messages is that HPV-linked cancer is both preventable – which is why we’re campaigning for the HPV vaccination to be offered to teenage boys as well as girls – and highly treatable if caught early.”

Experts warn that it will be decades before we start to see cases falling.

“Even if we start vaccinating girls and boys now against HPV, the benefits won’t be seen for at least 20 years,” says consultant clinical oncologist Dr Duncan Gilbert. Meanwhile, David Winterflood, of the Anal Cancer Foundation, says sufferers frequently experience shame and social isolation, due to misconceptions and ignorance about the cause of the disease and how it is transmitted.

“Not that long ago people were embarrassed to talk about breast, bowel, prostate and testicular cancer, says Jill.

“Thankfully, that’s all changed. It would be great to see that happen with anal cancer, too.”


Research efforts will investigate approaches to develop novel immune therapies for HPV-associated cancers.



Campaigners say the £24m-a-year cost of immunising boys would save “a colossal amount further down the health chain”.

Campaigners say the jab – which 12 and 13-year-old girls get to immunise them against Human Papilloma Virus – would be “hugely beneficial” to boys as well.

HPV Action say the virus – which can be sexually transmitted – is responsible for 5% of all cancers worldwide.

“We have an incredible opportunity here to fight cancer with a simple jab,” said the charity’s spokesman Peter Baker.

“Most ways of fighting cancer involve losing weight or exercising more or changing lifestyles radically. This involves a simple vaccination which costs £45.”

It is estimated that vaccinating 367,000 boys aged 12 each year would cost £24m.

Mr Baker added: “We should be investing more in this programme because further down the health chain it costs a colossal amount of money to treat cancer.”

HPV has been linked to many cancers including throat, penile and anal.

Tristan Almada helped found the charity after his mother Paulette died from a cancer linked to HPV in 2010.

“We are effectively discriminating against half the population. Canada, Australia and the United States all vaccinate boys and girls. Why is Britain different?”

The actor Michael Douglas last year said his own throat cancer had been caused by HPV.

A Department of Health spokesman said they have started a review.

He said: “More than 80% of girls are now vaccinated against HPV, however we recognise that the current vaccination programme does not offer protection against HPV-related cancers to gay men, which is why the JCVI has set up a sub-committee to assess whether the programme should be extended to adolescent boys, men who have sex with men, or both.”

The Mirror – Professional body wants boys to be given HPV cancer jabs as well as girls

The Mirror

The jab protects against the human papilloma virus, which is linked to cancer. Since 2008 all girls aged 12 to 13 in England have been given it.

Boys should get the same vaccination as girls to protect them against a virus that can cause cancer, health campaigners demanded today.

The jab protects against the human papilloma virus, which is linked to a several types of cancer. Since 2008 all girls aged 12 to 13 in England have been given the HPV jab to help prevent cervical cancer.

Now HPV Action, a group ­representing 25 patient and professional bodies, is calling for the vaccine to be extended to boys as the virus is a “rapidly growing threat to men”.

Campaign director Peter Baker said: “Vaccinating girls alone is not enough Men can still get the virus from unvaccinated women as well as other men.

“It is unfair to deny boys in the UK the same level of protection as girls. Boys in other countries are routinely vaccinated. “

He added: “HPV vaccination is one of the easiest ways of preventing cancer.”


Nursing Times

Boys should receive the HPV jab which protects against the human papilloma virus, which has been linked to a number of cancers including oral cancer.

In 2008 the HPV vaccination programme was launched in England to vaccinate girls aged 12-13 to help prevent cervical cancer.

HPV Action, a group representing 25 patient and professional bodies, is calling for the vaccine to be extended to boys as well as girls. It said that HPV is a “real and rapidly growing health threat to UK men”.

A poll of 1,300 British parents found that almost two thirds, 64%, were in favour of the vaccine being offered to boys, a spokesman said.

The organisation estimates that rolling out the programme to include 367,000 boys a year would cost around £24m a year.

“Vaccinating girls alone is not enough to tackle HPV: men can still get the virus HPV from unvaccinated women from the UK and other countries or from other men,” said HPV Action’s campaign director Peter Baker.

“It is simply unfair to deny boys in the UK the same level of protection as girls or as boys in Australia and other countries where both sexes are now routinely vaccinated. HPV vaccination is one of the easiest ways of preventing cancer.”

In October 2013, the Joint Committee on Vaccination and Immunisation (JCVI) agreed to set up a sub-committee on HPV vaccination to assess, among other issues, the question of extending the programme.

A Department of Health spokeswoman said: “More than 80% of girls are now vaccinated against HPV however we recognise that the current vaccination programme does not offer protection against HPV related cancers for gay men.

“Which is why the JCVI has set up a sub-committee to assess whether the programme should be extended to adolescent boys, men who have sex with men, or both.”

Actor Michael Douglas hit the headlines in 2012 after he said his battle against throat cancer was caused by performing oral sex. The 69-year-old claimed his stage-four cancer was linked to the virus.


Vaccination campaign: The HPV jab that would save boys’ lives.


San Francisco Chronicle


Bloomberg Business

London financiers will swap suits for Lycra today as two teams race rowing boats from Barcelona to Ibiza in a campaign to include boys in vaccinations for a cancer-causing virus.

Bankers, commodities traders and one Olympic rower will brave searing heat and shipping lanes for three days in an effort to raise money and change public health policy on human papillomavirus. One aim of the 10-strong group is to lobby to change the U.K. vaccination program, which only treats girls.

“Men in 10 years’ time are more likely to have HPV-related cancer than women,” said Tristan Almada, a hedge fund executive who founded the campaign and is president of the Anal Cancer Foundation. “This is a gender-neutral virus that requires a gender-neutral vaccine.”

For two of the men, HPV is personal. Almada’s mother died of the virus-related anal cancer in 2010, and fellow rower Pierre Andurand’s mother is undergoing treatment. Their mothers’ names, Isabel and Danielle, have been given to the boats. HPV also causes cervical and penile cancer and may trigger 5 percent of all cancers, according to the NoMan is an Island campaign.

The cause is attracting senior figures from the finance world. Andurand founded hedge fund Andurand Capital Management LLP. Other rowers include Pierre Lacaze, chief executive officer of LCM Commodities, and executives from Goldman Sachs Group Inc.


HPV-related cancer can be prevented through vaccination. Yet stigma surrounding sexually-transmitted disease and HPV’s characterization as a woman’s issue, because of its links to cervical cancer, have prevented universal inoculation, Almada said. He has petitioned the Centers for Disease Control and Prevention in the U.S. since 2010 and has reported to the Joint Committee on Vaccination and Immunization, a body of the U.K. department of health, though policy remains unchanged.

The 200-mile Row to End HPV is designed to get people engaged with the issue, and “convey the urgency that got the world behind polio and smallpox,” said Almada, whose day job is at derivatives hedge fund Taurosso Capital, which he co-founded. The event will also raise money for grants and to collaborate with the medical profession in research.

The rowers range in age from 28 to 41, and while they include veterans of Ironman competitions and mountain climbing, all but two are novices on water. Even Mark Hunter, who won a gold medal for the U.K. in Beijing, confesses to having little experience of rowing at sea. Teams of two will row in two-hour shifts and navigate themselves. A support boat will be on standby.

The teams had raised about $700,000 toward their $1 million target on Friday. The race will be an annual event, Almada said.


Ibiza Spotlight

On 22nd July, two teams of five amateur rowers will be setting off on a gruelling 200 mile extreme endurance ocean race across the Mediterranean from Barcelona to Ibiza.

Fewer than four hundred people have successfully rowed across an ocean, but the motivation for these ten novice rowers, known as the ‘NOMEN” is profound; they are aiming to raise awareness about HPV – the carcinogen which causes 5% of cancer worldwide – and, in particular, its connection to men. This campaign highlights the fact that a gender-neutral virus requires a gender-neutral vaccine, and whilst it is known that men are equally prone to contracting HPV, at present only girls are vaccinated in the UK.

The race will also raise funds for the Anal Cancer Foundation‘s programs, and marks the third anniversary of the charity that Tristan Almada (one of the rowers) co-founded with his sisters when his mother passed away from HPV related anal cancer in 2010. More than just a physical test, the Med Row is a unique endurance experience, representing the struggle and isolation that can be experienced by cancer patients…especially those with a challenging stigma attached.

Joining Tristan on Team Isabel (named after his mum) is Dan Zelezinski, Edward Knight, Alex Von Moll and Chris Wardrop…none of whom have any rowing experience.

Team Danielle is named after Pierre Andurand’s mother who is currently undergoing treatment for recurrent HPV related anal cancer. Again, with zero rowing experience, Pierre is joined by Pierre Lacaze, Andrew Toumazi and Mark Hunter. As an Olympic rowing gold medallist and world champion, Mark has been coaching both teams, but in spite of his rowing background, he has no experience in ocean rowing.

The race has the backup of a support team of professionals, who will be keeping an eye on the teams’ welfare, steering them through busy shipping lanes, and ensuring that both boats comply with the race rules.

After 72 hours of constant rowing, the crews are expected to arrive in the Port of Ibiza onThursday 25th July where they will be greeted by friends, family and supporters, so if you are in Ibiza, please do go along to join in the celebrations and show your support of this amazing feat of endurance and dedication.

Trackers on the boats will provide the exact time of arrival in Ibiza, and you can follow progress, send messages of encouragement to the rowers and make a donation via their, Twitter @nomancampaign or


STORTFORD resident Dan Zelezinski has set off on the journey of a lifetime today (Monday, July 22) rowing 200 miles from Barcelona to Ibiza.

The 33-year-old married dad of three is taking part in the NOMAN is an Island 2013: Row to End HPV challenge.

It pits two teams of five amateur ocean rowers against each other to race across the Mediterranean.

The epic contest is expected to take three days and the aim is to raise awareness about HPV – the carcinogen that causes five per cent of cancers worldwide and its connection to men.

The current UK-wide Human Papillomavirus vaccination policy administered by the NHS through the school system is limited to females, with the aim of cutting rates of cervical cancer. The NOMAN campaign wants the same service to be offered to males.

A spokesman said: “We are campaigning to introduce global, gender-neutral vaccination to protect all children from the devastating carcinogen, HPV. While successful vaccination programmes for girls have been initiated in many countries, much less has been done to vaccinate males.

“We believe that vaccinating females only is inadequate, discriminatory, and fails to acknowledge that men must be included in policy in order to significantly decrease HPV-related cancers. Gender-neutral vaccination will reduce the impact of the most dangerous strains of human papillomavirus on both men and women. By taking action now, we have the power to stop an epidemic while reducing the economic and social burdens of treatment for cancer and genital warts.”

The race will also raise funds for the Anal Cancer Foundations.

After being coached how to row by Olympic gold medallist Mark Hunter, Dan and his fellow competitors will be relying on months of physical training to complete their task.

Former Bishop’s Stortford High School pupil Dan is a veteran of tough challenges. He has worked for

Goldman Sachs since graduating 12 years ago and since hanging up his rugby boots, he specialises in endurance sports. He has competed in numerous multi-sport events including an Ironman 70.3 series event in Belgium and lists the successful summit of a 6000m peak in the Himalayas as the toughest mental and physical challenge to date – closely followed by bath and bed time duties for his three children, who are under the age of four.

He said: “Like most parents, my wife and I want to do our upmost to ensure our children’s health. It really is very simple; the current gender specific vaccination programme in the UK is outdated, scientifically flawed and must end. I’m truly honoured to be involved in this event and continue to be amazed by the energy, passion and drive the founding members of the foundation display. They are the heartbeat of an organisation that will ultimately succeed in saving thousands of lives.”



ACRIA & GMHC: Achieve – Living with HIV
Fall 2011, page 6


The New York Times

Paulette Crowther’s three children were grown and she was plotting a midlife career change when a routine colonoscopy picked up cancer, but not of the colon — of the anus.

The diagnosis was a shock. Ms. Crowther, a 51-year-old mother of three from New York City, had had no symptoms and was feeling just fine. It felt like a bolt from the blue. The cancer had already spread.

But as Ms. Crowther and her children scoured the Internet for information, they couldn’t help but wonder whether the cancer could have been prevented, or caught earlier at least.

Some 80 to 90 percent of anal cancers are caused by the human papillomavirus, or HPV, the same kind of virus that causes cervical cancer. And decades earlier, when Ms. Crowther was in her 20s, she had been treated for cervical dysplasia, a condition that often precedes cervical cancer – and is also caused by an HPV infection.

If only she had known.

“We think Mom could have been saved if she’d been monitored and screened more often,” said Ms. Crowther’s oldest child, Justine Almada, 27. “Studies show that if you have cervical dysplasia, you’re at higher risk. At the very least, she should have been made aware of that.”

She added, “Anal cancer is quite treatable if it’s found early.”

The same types of human papillomavirus implicated in cervical cancer, HPV 16 and 18, are also linked to anal cancer. And in December, the Food and Drug Administration expanded the approved uses of the HPV vaccine Gardasil to include prevention of anal cancer and precancerous lesions.

Ms. Crowther — who was fiercely devoted to the brood she raised in Lower Manhattan, largely on her own after a divorce, and whom the children call their “best friend” — died last April. Within three months, Justine and her siblings, Tristan and Camille Almada, ages 25 and 23, had established the Anal Cancer Foundation.

The foundation’s aim is to raise awareness about the link between the human papillomavirus, an incredibly common sexually transmitted infection, and a whole list of cancers, each of which affects a relatively small number of people but which, taken together, affect tens of thousands. Besides anal cancer, HPV infections are linked to some gynecological cancers, like vulvar and vaginal cancers, certain penile cancers in men and certain head and neck cancers.

With a robust Web site — — and an expert scientific advisory board, the organization also aims to increase awareness about preventive screening, provide support to family members and caregivers and raise money for research on treatment, which remains limited for metastatic disease.

“What keeps us going is the thought that if someone had done this already, it could have prevented what happened to Mom,” said Camille, who recently stepped in to run the tax-exempt foundation.

The irony is that while Ms. Crowther was still alive, she never told anyone what kind of cancer she had. Experts say that’s not unusual for people with anal cancer, who often are ashamed of their disease. “The assumption most people make is that if you have anal cancer, you had anal sex,” Camille said. “That’s not true. Heterosexual men also have HPV in their anus, because HPV is so prevalent. But also: who cares if you had anal sex?”

Dr. Cathy Eng, an associate professor in gastrointestinal medical oncology at M.D. Anderson Cancer Center in Houston, said: “It’s really important to emphasize that the average person is in fact a female in her late 50s, early 60s — that’s the average patient.” The actress Farrah Fawcett, of “Charlie’s Angels” fame, who documented her battle with anal cancer on film, was fairly typical; she was 62 when she died of the disease in 2009. Dr. Eng added, “People associate anal cancer in general with men who have sex with men who are H.I.V.-positive; that’s not the case.”

While men who have sex with men are at elevated risk for developing anal cancer, the disease strikes more women than men: cases are diagnosed in some 2,000 men and 3,260 women each year in the United States. The disease is on the rise, with new diagnoses increasing by 2 percent a year in both men and women, according to national cancer statistics. Each year, 720 people die of anal cancer.

Other risk factors include having a history of cervical cancer or other gynecological malignancies, having a suppressed immune system, an atypical Pap smear and testing positive for HPV 16 or 18. Having had multiple sex partners, having a history of sexually transmitted disease and having had receptive anal intercourse, even without full penetration, likewise increase risk.

Early symptoms like blood in the stool or a feeling of pressure can easily be mistaken for hemorrhoids. “An important message is: if your hemorrhoids don’t get better, you need to talk to your doctor,” Dr. Eng said.

There is no clear medical consensus on screening for anal cancer. Choices include a digital rectal exam or digital anal exam, done as part of a physical or gynecological checkup, or an anal Pap smear. Dr. Joel Palefsky, an infectious disease specialist at the University of California, San Francisco, offers a screening procedure called high-resolution anoscopy, which may be an especially sensitive screening technique. But it is not widely available.

“If a woman has had cervical cancer, she is clearly at increased risk for anal cancer,” Dr. Palefsky said. “We’ve known about the connection for a while. People didn’t pay a lot of attention until recently.”

Another of the foundation’s goals is to destigmatize the disease and end the isolation many patients feel. “When you have cancer, you shouldn’t be ashamed of it; it’s terrible enough to have cancer,” Camille said.