Position paper—HPV and the primary prevention of cancer; improving vaccine uptake by paediatricians

• Published in: European journal of pediatrics Vol. 170; no. 3; pp. 309 - 321
• Main Authors: Ramet, José, van Esso, Diego, Meszner, Zsofia
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.03.2011; Springer; Springer Nature B.V
• Subjects: Adolescence; Anus; Biological and medical sciences; Breast cancer; Cancer screening; Cancer vaccines; Cervical cancer; Cervix; Condyloma acuminatum; Early Detection of Cancer; Female; General aspects; Human papillomavirus; Humans; Immunization; Immunogenicity; Male; Medical sciences; Medical screening; Medicine; Medicine & Public Health; Miscellaneous; Papilloma; Papillomaviridae; Papillomavirus Infections - epidemiology; Papillomavirus Infections - physiopathology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines; Pediatrics; Pediatrics - standards; Penis; Prevention; Prevention and actions; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Review; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - prevention & control; Uterine Cervical Neoplasms - virology; Vaccination; Vaccines; Vulva; Warts; Human papillomavirus; Quadrivalent HPV vaccine; Bivalent HPV vaccine; Vaccination; Cervical cancer; Paediatrics; Pediatrics; Bivalent vaccine; Papovaviridae; Papillomavirus; Prevention; Improvement; Child; Public health; Primary cancer; Human; Position; Malignant tumor; Uptake; Female genital diseases; Infection; Virus; Immunoprophylaxis; Pediatrician; Viral disease; Paper; Uterine cervix diseases; Cancer
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-010-1265-9

A large proportion of sexually active adults are infected with the human papillomaviruses (HPVs). Although largely asymptomatic, some types of HPVs (HPV-16, HPV-18) which infect the genitalia are known to cause cancers, including cervical cancer. Cervical cancer is an important public health concern and is the second most clinically important cancer to breast cancer in women aged 15–44 years. Until recently, cervical cancer strategies focussed on screening. However, as adolescents become sexually active at a much younger age, the focus is on the use of vaccination as an effective measure to prevent progression of HPV infection to cancer. HPV is also involved in the aetiology of cancers of the anus, vagina, vulva and penis as well as genital warts and laryngeal papillomatosis in young children. Primary prevention through vaccination is now possible in Europe using either the quadrivalent HPV vaccine, Gardasil® (Sanofi Pasteur MSD), or the bivalent HPV vaccine, Cervarix® (GSK), which are both highly immunogenic, with their effects persisting for at least 5 years. HPV vaccines are well tolerated, with serious vaccine-related events occurring in less than 0.1% of patients for both vaccines. Here, we review the possibilities for utilising vaccination programmes alongside current cervical cancer screening in comprehensive cervical cancer prevention programmes. The European Academy of Paediatrics Scientific Working Group on Vaccination concluded that the use of HPV vaccines will have a significant impact in primary prevention of cancers and other HPV-related disease.