Risk-based prophylactic HPV vaccination of heterosexual US men aged 27 to 45 years for prevention of oropharyngeal cancer.

Chaturvedi, Anil K; Haber, Gregory; Graubard, Barry I; Cheung, Li C; Gillison, Maura L; Landy, Rebecca · J Infect Dis · 2026

basic_science · Level V

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Abstract

HPV vaccination of US individuals aged 27-45 years is recommended through shared clinical decision-making. To enable shared decision-making, we used a microsimulation-based state-transition model to develop and validate a risk-prediction model to identify heterosexual men aged 27-45 at high-risk of acquiring oral HPV16 infections. A risk model for incident oral HPV16 infections had good discrimination (AUC=0.73) and calibration (E/O=1.01) in internal cross-validation. Compared to vaccinating all men aged 27-45, vaccinating 44% of men with highest model-predicted risk would prevent 80% of incident oral HPV16 infections through age 45 and reduce the NNV to prevent 1 infection by 45% (184 vs. 100).