Impact of HPV immunization on the detection of cervical disease

Abstract

Human papillomavirus (HPV) is the primary cause of cervical cancer and genital warts. The development of HPV vaccines has been a major advance in the prevention of these diseases. Recent studies have shown promising early effects of HPV immunization programs on cervical abnormalities and genital warts, with evidence of herd immunity against genital warts also emerging in Australia. Further studies are required to not only continue monitoring the effect of the HPV immunization on the incidence of these diseases, but also to establish the effect the immunization will have on cervical screening programs and the performance of colposcopy.

Keywords::

• cervical screening
• CIN
• colposcopy
• genital warts
• HPV
• HPV vaccine

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• HPV is the primary cause of cervical cancer, as well as other anogenital cancers, oropharyngeal cancers and genital warts.

• The introduction of a vaccination against HPV6, 11, 16 and 18 has been a major advance in the prevention of these diseases.

• Both the quadrivalent and bivalent vaccines have been shown to be highly effective in Phase III clinical trials.

• Early data indicate that the introduction of the quadrivalent immunization has led to a decrease in incidence of genital warts in young women who have received the vaccine.

• Incidence of genital warts has also decreased in young heterosexual men and unvaccinated young women, indicating that herd immunity may be created with high uptake rates.

• The incidence of high-grade cervical abnormalities has decreased in women under the age of 18 years following the introduction of the immunization [12].

• The decrease of HPV16-positive cervical lesions may have an impact on the performance of colposcopy in cervical screening programs beyond that expected with lower disease prevalence.

• Further studies are required in the future to determine the long-term effect of the HPV immunization on genital warts, cervical abnormalities, anogenital and oropharyngeal cancers.

Notes