Anticipated Efficacy of HPV Vaccination in Prophylaxis Against Nongenital Cancers

Česká verzia

Authors: B. Sehnal ¹; N. Vojáčková ²; D. Driák ¹ ; E. Kmoníčková ³; D. Vaňousová ²; K. Maxová ¹; H. Neumannová ¹; J. Sláma ⁴
Authors place of work: Onkogynekologické centrum, Gynekologicko‑porodnická klinika 1. LF UK a Nemocnice Na Bulovce, Praha ¹; Dermatovenerologická klinika 2. LF UK a Nemocnice Na Bulovce, Praha ²; Ústav radiační onkologie, Komplexní onkologické centrum, 1. LF UK a Nemocnice Na Bulovce, Praha ³; Onkogynekologické centrum, Gynekologicko-porodnická klinika 1. LF UK a VFN v Praze ⁴
Published in the journal: Klin Onkol 2014; 27(4): 239-246
Category: Review

Summary

Background:
There is a considerable number of studies on the efficacy HPV (human papillomavirus) vaccination against different cancers but relevant information is scattered in diverse journals. This paper is a review summarizing current knowledge of the potential of HPV vaccination against all HPV related cancers.

Aim:
HPV infection is probably the most frequent sexually transmitted disease. At least 13 HPV genotypes are classified as carcinogenic or probably carcinogenic in respect to cervical cancer. Almost 100% of cervical cancers are linked to HPV infection. HPV 16 and HPV 18 are the most frequently involved genotypes and account together for approximately 70% of cervical cancer in the world. Persistent high‑risk HPV infection is responsible for a significant proportion of vulvar, vaginal, anal and penile carcinomas. The virus has also been implicated in oncogenesis of head and neck cancers, including oropharyngeal cancers. HPV infection can play an important role in cancerogenesis of lung, esophagus, breast, and colon and rectum. On the contrary, published results indicate that HPV infection is not associated with prostate oncogenesis. Strong predominance of HPV 16 has been reported for all HPV‑associated cancer sites. Generally, it is estimated that approximately 5.2% of all cancers are associated with oncogenic HPV infection. Currently, there are two vaccines on the market; quadrivalent Silgard^® (Gardasil^®) and bivalent Cervarix^TM. Large trials for both vaccines have shown efficacy against HPV‑related infection and disease. Efficacy has been very high in HPV naive subjects to vaccine related types. While HPV vaccination is currently approved for the prevention of cervical cancer, it also has the potential in the prevention of all HPV‑associated malignancies. The Czech republic belongs to countries that cover HPV vaccination of girls at the age of 13– 14 years by general health insurance. Overall impact of this vaccination remains to be evaluated. The new issues of the role of HPV in oncogenesis, as well as the potential effect of HPV vaccination against HPV‑related nongenital cancers are discussed.

Conclusion:
Approximately 5.2% of all human cancers are associated with oncogenic human papillomavirus infection. HPV vaccination against the most risky HPV oncotypes may cause a significant reduction of these cancers mainly in the HPV naive population.

Key words:
human papillomavirus – anal cancer – penile cancer – head and neck cancer – esophageal cancer – lung cancer – colorectal cancer – recurrent respiratory papillomatosis

This study was supported by grant of Integral Agency of the Czech Ministry of Health No. NT14079-3/2013 and by project PRVOUK-P27/LF1/1.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
2. 2. 2014

Accepted:
21. 5. 2014

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