Opinion statement
In the United States, there are 11,150 cases and 3670 deaths projected due to invasive cervical cancer for 2007. Approximately 500,000 new cases and 274,000 deaths will occur in women throughout the world. Human papillomavirus (HPV) has been designated by the World Health Organization (WHO) as a “necessary cause” of cervical cancer. There are 6.2 million new cases of HPV diagnosed each year. In addition to cervical cancer, the virus has also been implicated in vaginal, vulvar, penile, anal, and head and neck cancers. Current methods for prevention of cervical cancer include Pap smears, HPV testing, ablative procedures, cervical conization, and hysterectomy. These are costly as well as invasive. The HPV vaccine is the most recent breakthrough for the prevention of cervical cancer. The quadrivalent HPV vaccine (GardasilTM) covers types 6, 11, 16, & 18. The bivalent vaccine (CervarixTM) covers types 16 & 18, and is expected to come out in the early part of 2007. Approximately 70% of cervical cancer is caused by HPV types 16 & 18. HPV types 6 &11 are responsible for 90% of anogenital warts. Females of ages 11–12 and those prior to their sexual debut should be vaccinated, with all females in the age range of 9–26 also eligible. This vaccination strategy can prevent the above HPV infections, cervical dysplasia, and possibly cervical cancer.
Similar content being viewed by others
References and Recommended Reading
Papers of particular interest, published recently, has been highlighted as: •Of importance ••Of major importance
Centers for Disease Control and Prevention: Quadrivalent Human Papillomavirus Vaccine. Recommendations of the Advisory Committee on Immunization Practices. MMWR 2007, 56(Early Release):1–24
ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists. Number 61, April 2005. Human Papillomavirus. Obstet Gynecol 2005, 105:905–918
Parkin DM, Bray F, Ferlay J, Pisani P: Global cancer statistics, 2002. CA Cancer J Clin 2005, 55:74–108
Pagliusi SR, Teresa Aguado M. Efficacy and other milestones for human papillomavirus vaccine introduction. Vaccine 2004;23:569–578
World health report 2004: Changing history. Statistical annex. World health organization. 2004 [updated 2004; cited]; http://www/who.int/whr/2004/en/index/htm
••Bosch FX, Lorincz A, Munoz N, Meijer CJ, Shah KV. The causal relation between human papillomavirus in cervical cancer. J Clin Pathol 2002;55:244–265
This is a comprehensive review of the important studies documenting the causal role of human papillomavirus and cervical cancer.
Schiffman M, Kjaer SK: Chapter 2: Natural history of anogenital human papillomavirus infection and neoplasia. J Natl Cancer Inst Monogr 2003, 31:14–19
Syrjanen S. Human Papillomaviruses in head and neck carcinomas. N Engl J Med 2007;356:1993–1995
•Koutsky LA, Ault KA, Wheeler CM, Brown DR, Barr E, Alvarez FB, Chiacchierini LM, Jansen KU. A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med 2002;347:1645–1651.
This randomized double-blind study showed that the administration of the HPV16 vaccine decreased the incidence of HPV16 infection and HPV16-related CIN.
••Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV, Snijders PJ, Meijer CJ. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003;348:518–527.
This pooled case-control study identified 15 HPV types as high risk, 3 HPV types as probable high risk, and 12 HPV types as low risk.
Kjaer SK, Chackerian B, van den Brule AJ, Svare EI, Paull G, Walbomers JM, Schiller JT, Bock JE, Sherman ME, Lowy DR, Meijer CL. High-risk human papillomavirus is sexually transmitted: evidence from a follow-up study of virgins starting sexual activity (intercourse). Cancer Epidemiol Biomarkers Prev 2001;10:101–106.
Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM, Stine K: Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women. Am J Public Health 2001, 91:947–952
Schiller JT, Davies P. Delivering on the promise: HPV vaccines and cervical cancer. Nat Rev Microbiol 2004;2:343–347.
Franco EL, Villa LL, Sobrinho JP, Prado JM, Rousseau MC, Desy M, Rohan TE. Epidemiology of acquisition and clearance of cervical human Papillomavirus infection in women from a high-risk area for cervical cancer. J Infect Dis 1999;180:1415–1423.
Molano M, Van den Brule A, Plummer M, Weiderpass E, Posso H, Arslan A, Meijer CJ, Munoz N, Franceschi S. Determinants of clearance of human Papillomavirus infections in Colombian women with normal cytology: a population-based, 5-year follow-up study. Am J Epidemiol. 2003;158:486–494.
Tjalma WA, van Damme P. Who should be vaccinated against human papillomavirus? Int J Gynecol Cancer 2006;16:1498–1499.
Human Papillomavirus (HPV): http://www.acog.org/departments/govtrel/FactSheetHPV20070223.pdf
Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, Feuer EJ, Thun MJ. Cancer statistics,2004. CA Cancer J Clin 2004;54:8–29.
Clavel C, Masure M, Bory JP, Putaud I, Mangeonjean C, Lorenzato M, Nazeyrollas P, Gabriel R, Quereux C, Birembaut P. Human Papillomavirus testing in primary screening for the detection of high-grade cervical lesions: a study of 7932 women. Br J Cancer 2001;84:616–623.
Hutchinson ML, Zahniser DJ, Sherman ME, Herrero R, Alfaro M, Bratti MC, Hildesheim A, Lorincz AT, Greenberg MD, Morales J, Schiffman M. Utility of liquid-based cytology for cervical carcinoma screening: results of a population-based study conducted in a region of Costa Rica with a high incidence of cervical carcinoma. Cancer 1999;87:48–55.
ACOG Committee Opinion No. 344: Human Papillomavirus vaccination. Obstet Gynecol 2006, 108:699–705
ACOG Committee Opinion #300: Cervical cancer screening in adolescents. Obstet Gynecol 2004, 104:885–889
Block SL, Nolan T, Sattler C, Barr E, Giacoletti KE, Marchant CD, Castellsague X, Rusche SA, Lukac S, Bryan JT, Cavanaugh PF, Jr, Reisinger KS. Comparison of the immunogenicity and reactogenicity of a prophylactic quadrivalent human Papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in male and female adolescents and young adult women. Pediatrics 2006;118:2135–2145.
Frazer IH, Cox JT, Mayeaux EJ, Jr, Franco EL, Moscicki AB, Palefsky JM, Ferris DG, Ferenczy AS, Villa LL: Advances in prevention of cervical cancer and other human Papillomavirus-related diseases. Pediatr Infect Dis J 2006, 25:S65–S81, quiz S82
Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, Zahaf T, Innis B, Naud P, De Carvalho NS, Roteli-Martins CM, Teixeira J, Blatter MM, Korn AP, Quint W, Dubin G. Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human Papillomavirus types 16 and 18 in young women: a randomized controlled trial. Lancet 2004;364:1757–1765.
•Harper DM, Franco EL, Wheeler CM, Moscicki AB, Romanowski B, Roteli-Martins CM, Jenkins D, Schuind A, Costa Clemens SA, Dubin G. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomized control trial. Lancet 2006;367:1247–1255.
This randomized controlled study showed that the bivalent L1 virus-like particle vaccine was efficacious for up to 4.5 years.
Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med 2007, 356:1915–1927.
This randomized double-blind study showed that vaccination with the quadrivalent vaccine of women not previously been infected with HPV16 and 18 significantly reduced their incidence of high-grade CIN related to HPV16 & 18.
••Garland SM, Hernandez-Avila M, Wheeler CM, Perez G, Harper DM, Leodolter S, Tang GW, Ferris DG, Steben M, Bryan J, Taddeo FJ, Railkar R, Esser MT, Sings HL, Nelson M, Boslego J, Sattler C, Barr E, Koutsky LA. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med 2007;356:1928–1943.
This randomized placebo-controlled, double-blind study demonstrated that the quadrivalent vaccine significantly decreased the incidence of HPV-related anogenital diseases in women aged 16–24.
Food and Drug Administration. Product approval information-licensing action [package insert]. Gardasil (quadrivalent human papillomavirus types 6, 11, 16, and 18). Merck & Co., Whitehouse Station, NJ. Available at http://www.fda.gov/cber/label/HPVmer060806LB.pdf
Centers for Disease Control and Prevention: General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP). MMWR 2002, 51(No. RR-2):1–35
HPV vaccine—ACOG recommendations [cited]; Available from: http://www.acog.org/departments/dept_notice.cfm?recno=7&bulletin=3945
Noakes K, Yarwood J, Salisbury D. Parental response to the introduction of a vaccine against human papillomavirus. Hum Vaccin 2006;2:243–248.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hakim, A.A., Lin, P.S., Wilczynski, S. et al. Indications and Efficacy of the Human Papillomavirus Vaccine. Curr. Treat. Options in Oncol. 8, 393–401 (2007). https://doi.org/10.1007/s11864-007-0050-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11864-007-0050-0