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Human papillomavirus (including vaccination)
Authors:Richard PeevorAlison N Fiander
Institution:Richard Peevor MBBS MRCOG is a Sub-specialist Trainee in Gynaecological Oncology at the HPV Research Group, Department of Obstetrics and Gynaecology, Wales College of Medicine, Cardiff University, Cardiff, UK. Conflicts of interest: none declared; Alison N Fiander BM MSc DM FRCOG is Chair of Obstetrics and Gynaecology at Wales College of Medicine, Cardiff University, Cardiff, UK. Conflicts of interest: none declared
Abstract:Human papillomavirus (HPV) is responsible for 99.7% of cervical cancer. Worldwide, cervical cancer causes more deaths than any other cancer, almost two per minute. Over 200 types of HPV have been identified. HPV is transmitted by skin-to-skin contact. Most HPV infections are cleared by the immune system; persisting infections can cause intra-epithelial neoplasia and invasive disease. Prophylactic HPV vaccines have been developed and prevent disease caused by the included HPV types. Current vaccines could prevent 70–75% cases of cervical cancer. The UK, in 2008 added HPV vaccination to the national immunization programme. The vaccines are safe and well tolerated. It is likely that the benefits will be seen over a 15–20 year period. Tests for HPV have been developed and are being evaluated as to their possible role in clinical practice. Research is ongoing regarding therapeutic HPV vaccination and improving prophylactic vaccines to prevent more cases of cancer.
Keywords:cancer screening  cervical intra-epithelial neoplasia  human papillomavirus  papillomavirus vaccines  uterine cervical neoplasms
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