Prevention and Screening of HPV Malignancies

Authors

Kristina R Dahlstrom
Andrew T Day
Erich M Sturgis

Publication Date

10-1-2021

Journal

Seminars in Radiation Oncology

DOI

10.1016/j.semradonc.2021.02.011

PMID

34455985

PMCID

PMC10124108

PubMedCentral® Posted Date

4-24-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Adolescent, Alphapapillomavirus, Anus Neoplasms, Early Detection of Cancer, Female, Humans, Male, Oropharyngeal Neoplasms, Papillomaviridae, Papillomavirus Infections, Uterine Cervical Neoplasms

Abstract

It is estimated that 5% of the global cancer burden, or approximately 690,000 cancer cases annually, is attributable to human papillomavirus (HPV). Primary prevention through prophylactic vaccination is the best option for reducing the burden of HPV-related cancers. Most high-income countries (HICs) have introduced the HPV vaccine and are routinely vaccinating adolescent boys and girls. Unfortunately, although they suffer the greatest morbidity and mortality due to HPV-related cancers, many lower- and middle-income countries (LMICs) have been unable to initiate and sustain vaccination programs. Secondary prevention in the form of screening has led to substantial declines in cervical cancer incidence in areas with established screening programs, but LMICs with absent or inadequate screening programs have high incidence rates. Meanwhile, HICs have seen incidence rates of anal and oropharyngeal cancers rise owing to the limited availability of organized screening for anal cancer and no validated screening options for oropharyngeal cancer. The implementation of screening programs for individuals at high risk of these cancers has the potential to reduce the burden of cervical cancer in LMICs, of anal and oropharyngeal cancers in HICs, and of anal cancer for highly selected HIV+ populations in LMICs. This review will discuss primary prevention of HPV-related cancers through vaccination and secondary prevention through screening of cervical, anal, and oropharyngeal cancers. Areas of concern and highlights of successes already achieved are included.