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PART 1

THE CASE FOR HPV VACCINATION

Worldwide, about 2 million new cancer cases are caused by infectious diseases every year.[1] More than 600,000 of these are caused by human papillomaviruses (Figure 1), viruses common in the U.S. and around the world. The discovery that infectious agents can cause cancers opened the door for a new cancer prevention strategy—vaccination. Vaccines against infectious agents have been one of the greatest success stories in public health, leading to eradication of smallpox and drastically reducing the incidence and severity of many other deadly diseases attributable to infectious agents. Vaccines capable of preventing cancers have been a goal for many years, but until recently, only one had been developed—a vaccine against hepatitis B virus, a leading cause of liver cancer.

HPV vaccines provide an effective, safe means to prevent diseases caused by some of the most dangerous types of HPV: HPV16 and HPV18. Together, these two HPV types are responsible for more than 400,000 cases of cancer around the world each year (Table 1), including 22,000 in the United States (Table 2).* Yet, in the U.S., only one-third of adolescent girls and less than 7 percent of adolescent boys have received all three recommended vaccine doses.[2] The President's Cancer Panel finds underuse of HPV vaccines a serious, but correctable threat to progress against cancer.

Figure 1

Figure 1. Numbers of Cancers Caused by HPV Worldwide Each Year

Note: Global estimates of genital warts and recurrent respiratory papillomatosis incidence are not available.

Source: de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22575588

Table 1

Cancers Attributed to HPV Worldwide

Cancer Site Number of Cancers Probably Caused by HPV (a) Percent of HPV-Associated Cancers Probably Caused by HPV16 or 18 (b) Number of Cancers Probably Caused by HPV16 or 18
Anus 24,000 92 22,100
Cervix 530,000 70 371,000
Oropharynx 22,000 89 19,600
Penis 11,000 63 6,900
Vagina 9,000 80 7,200
Vulva 12,000 80 9,600
TOTAL 608,000 436,400

(a) de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22575588

(b) Gillison ML, Chaturvedi AK, Lowy DR. HPV prophylactic vaccines and the potential prevention of noncervical cancers in both men and women. Cancer. 2008;113(10 Suppl):3036-46. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18980286


Table 2

U.S. Cancers Attributed to HPV

Cancer Site Average # Cancers Per Year at Site (a) Percent Probably Caused by HPV (a) Number Probably Caused by HPV (a) Percent HPV Cancers Probably Caused by HPV16 or 18 (b) Number Probably Caused by HPV16 or 18
Anus 4,767 93 4,500 93 4,200
Cervix 11,967 96 11,500 76 8,700
Oropharynx 11,726 63 7,400 95 7,000
Penis 1,046 36 400 87 300
Vagina 729 64 500 88 400
Vulva 3,136 51 1,600 86 1,400
TOTAL 33,371   25,900   22,000

(a) Centers for Disease Control and Prevention. Human papillomavirus-associated cancers—United States, 2004-2008. MMWR. 2012 Apr 20;61(15):258-61. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22513527

(b) Gillison ML, Chaturvedi AK, Lowy DR. HPV prophylactic vaccines and the potential prevention of noncervical cancers in both men and women. Cancer. 2008;113(10 Suppl):3036-46. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18980286

Footnotes

* Additional information on HPV and HPV vaccines is available from NCI, CDC, and the GAVI Alliance [PDF Download].

References

  1. de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22575588
  2. Centers for Disease Control and Prevention. National and state vaccination coverage among adolescents aged 13-17 years—United States, 2012. MMWR. 2013;62(34):685-93. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23985496