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

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

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Footnotes

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

References

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
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