HPV vaccines – how to get the maximum protection


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Margaret Stanley1
1University of Cambridge

Abstract

Viral infections cause at least 15% of all human cancers; one of the most important oncogenic viruses is the human papillomavirus (HPV) a causal agent in 5% of all malignancies. About 13 HPV types are high risk or cancer causing HPVs with HPV 16 and 18 being the most important. Infection with one of these oncogenic HPVs is the cause of carcinoma of the cervix in women, the 3rd commonest cancer in women worldwide. HPV associated cancers are not confined to the cervix and HPV infection is implicated in the development of a proportion of vaginal, vulval, anal penile and head and neck cancers in both men and women. Importantly the incidence of HPV related cancers in these sites, particularly anal carcinomas and tonsillar carcinomas is increasing particularly in men. Prophylactic HPV vaccines are now included in the national immunisation programmes in many countries with young adolescent peripubertal girls the usual cohort for immunisation. Population effectiveness in women is now being demonstrated in those countries with high vaccine coverage. Since HPV associated cancers in men are increasing in incidence an issue of contemporary debate is extending HPV vaccination to adolescent boys.