The case highlights a lack of HPV screening services for men in Ireland, according to a doctor at the hospital
New research has highlighted a lack of HPV screening services for men after a 44-year-old in Waterford died months after being diagnosed with “large, extremely tender, ulcerating, malodorous” genital warts.
The patient attended University Hospital Waterford, where doctors observed warts covering the majority of the area around his anus and one of his buttocks, as well as on his perineum, extending down his thigh. He reported having the condition for two years, during which time he had lost 25kg. He was a heavy smoker and drank the equivalent of around 56 pints per week. He was not sexually active and denied previous sexual intercourse with men. READ MORE: Two in five healthcare workers fear Covid-19 vaccine will have serious side-effects, study findsDoctors at the hospital were concerned that his genital warts could develop into cancer, but a multidisciplinary meeting concluded that surgery was not an option due to the extent of the disease. They performed a loop colostomy so he could pass stool through a stoma, but then the patient absconded from care and was missing for six months. When he returned, his condition had deteriorated, according to a case report published in the Irish Medical Journal. Radiological imaging showed that the disease had progressed, and histology analysis confirmed that he had developed invasive squamous cell carcinoma – a type of skin cancer that has spread elsewhere in the body. The author of the report noted that the patient was “too frail” at this point for therapy, and instead began a course of specialised palliative care. He declined rapidly and died within two months. Discussing what may have caused the man’s genital warts to become cancerous, the author said his “significant” alcohol consumption could have made him predisposed to immunosuppression. However, she also suggested that his genital warts had been “persistently irritated”, and this could have led to the development of various HPV subtypes that can cause cancer. The patient’s “self-neglect” and reduced healthcare engagement had hindered the timely monitoring of his condition, which prevented timely intervention and led to the progression of the disease, she added. “This case emphasises the importance of advocating for patients to engage with healthcare services. It also demonstrates that there is still a lack of screening programmes in Ireland for HPV in men, particularly outside of the high-risk population.” Last year, the HPV vaccination programme was extended to men under the age of 22. The vaccine protects against the types of HPV that cause between 90 and 95 percent of HPV-related anal cancer, and 90 percent of genital warts. Recent research found that almost one in three men over 15 is infected with at least one genital HPV, and one in five is infected with one or more high-risk HPV types. Sign up to the Irish Mirror's daily newsletter here and get breaking news and top stories direct to your inbox.
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