Can cervical cancer be eradicated by prophylactic HPV vaccination: Challenges to vaccine implementation.
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Date
2009-09
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Abstract
Cervical cancer is the first cancer to be shown to be 100 per cent attributable to a virus; oncogenic human
papillomaviruses (HPV), particularly types 16 and 18, collectively worldwide contribute to 70 per cent
squamous cell carcinomas, 85 per cent of adenocarcinomas. Cervical cancer is the second commonest
cancer of women, yet largely preventable with high-quality, well-organized screening of the appropriate
population. Screening programmes are either nonexistent, or function opportunistically in many poorer
countries, resulting in high incidence and mortality. Recently developed, prophylactic HPV vaccines
against HPV 16, 18, as cervical cancer preventative vaccines, in phase 3 clinical trials have been shown,
to be highly efficacious, safe and immunogenic. With the potential for cross protection against related
HPV types, estimates for prevention are in the order of 75 to 80 per cent. Thus a further option exists
in the battle to reduce these cancers in women. Challenges however include implementing a vaccination
programme with wide coverage to the target populations to be a successful public health tool, integration
and maintenance of current screening programmes where they are in existence, the need for reduced costs
of the current vaccines, long-term immunogenicity (will there be a need for further doses?), appropriate
education messages to the general community, governments, as well as the medical profession.
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Human papillomavirus, implementation, vaccination
Citation
Garland Suzanne M. Can cervical cancer be eradicated by prophylactic HPV vaccination: Challenges to vaccine implementation. Indian Journal of Medical Research. 2009 Sept; 130(3): 311-321.