DEAR DR. ROACH: In a recent column, you mentioned that the HPV (human papillomavirus) vaccine prevents neck and head cancer in men. I am 75 and do not recall ever getting an HPV vaccine. Should I get one now? — J.L.I.

ANSWER: For many years, tobacco (smoking, snuff, chewing tobacco, etc.) was the biggest risk for head and neck cancer. But recently, HPV has become the leading cause of head and neck cancer, with 60% to 70% of all head and neck cancers being HPV-related.

The HPV vaccine prevents several types of HPV from infecting a person and causing warts. Certain types of HPV predispose people to developing cancer, and these types are the ones that are targeted by the vaccine.

The vaccine has proven to be very effective at preventing cervical cancer in women over the years. But since the vaccine was released, more evidence is accumulating that will also likely reduce the risk of head and neck cancer in men, since it is proven to be effective at preventing the virus from infecting the oral cavity. Real-world data show an 80% to 99% reduced risk in acquiring HPV-related head and neck cancers.

The vaccine is best given before the person gets exposed to HPV (although there still may be some benefit in giving the vaccine to people who have already been exposed). This is why the vaccine is recommended at a young age before there is likely exposure, which is commonly through sexual contact.

The vaccine is only indicated by the Food and Drug Administration until the age of 45. I’ve had a handful of patients where I’ve given the vaccine beyond the age limit. This has normally been when a person who has been in a long-term relationship or has been abstinent for many years considers getting a new sexual partner. A thorough understanding of the risks and benefits (including the cost as it is not normally covered by insurance after age 45) is mandatory before giving a vaccine in a non-approved fashion.

If you are in a stable relationship and are not planning to have new sexual partners, the benefit of vaccination is small. Giving the vaccine to all members of a community can bring the level of HPV-associated cancers (cervical as well as head and neck) to zero within two generations, as we are now seeing in several countries.

DEAR DR. ROACH: I’ve always had some abnormal blood tests. I have an elevated HDL cholesterol, and my hemoglobin count is 15.7 g/dL. I have tested negative for polycythemia. I also have an alkaline phosphatase of 145 IU/L. Can I donate blood safely? — R.J.S.

ANSWER: You do have some borderline-high test results. A high HDL level is usually a sign of good heart health, although a minority of people have an abnormal HDL level that is not protective. People with high HDL and a strong family history of heart disease should seek out an expert on lipids.

A hemoglobin level of 15.7 is borderline high. Polycythemia vera (PV) is a myeloproliferative disorder and a type of blood cancer that would keep a person from donating blood. Since you do not have PV, this won’t keep you from donating. A hemoglobin of 15.7 very seldom signifies PV, but your doctor is being very cautious.

Alkaline phosphatase is an enzyme that is found in the liver and bones. High levels can come from blocked bile ducts due to many causes or some kinds of bone disease, especially Paget’s disease of bone. Your level is just in the normal range, making these conditions unlikely.

It is worth following up with your doctor on these issues, but none of them should keep you from donating blood. The blood bank does their own set of tests to keep the blood supply safe.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc.

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