Update on human papillomavirus vaccination: Where are we now?

作     者：Eloise Chapman-Davis Lauren E Dockery Kendall Griffith Caroline Stroup 

作者机构：Department of Obstetrics and GynecologyDivision of Gynecologic Oncology Tufts University School of Medicine Tufts Medical Center 

出 版 物：《World Journal of Obstetrics and Gynecology》 (世界妇产科杂志)

年 卷 期：2016年第5卷第1期

页      面：5-15页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Human papillomavirus Vaccines Cervical cancer Cancer prevention Public health 

摘      要：Infection with human papillomavirus(HPV) is the major cause of pre-invasive and invasive lesions of the urogenital tract, resulting in morbidity and mortality worldwide. HPV-related infection is responsible for most cases of cervical cancer, a leading cause of cancer death in women worldwide. Developed countries have screening programs in place to detect precancerous lesions at early stages; in resource-limited settings however, HPV related diseases are often identified in advanced stages. This is due to limitations in the availability and roll out of effective screening programs. The relatively recent availability of the HPV vaccine has provided a new public health opportunity to decrease the incidence of HPV-related disease. The high mortality rates seen in developing countries could be reduced through effective implementation of HPV vaccination programs. Large trials have proven the efficacy of bivalent, quadrivalent vaccine and most recently 9-valent vaccine. Uptake in vaccination remains low due to multiple barriers including lack of education, lack of access, and costs. New strategies are being assessed to increase access, increase knowledge and reduce costs that may result in feasible vaccination programs worldwide. The goal of this article is to review the effectiveness and safety of the current HPV vaccines available, vaccine delivery strategies, cost effectiveness, and efforts to improve the acceptability. A literature search was conducted through Pub Med using the terms HPV vaccination, and safety, and males, and acceptability and strategies, and cost effectiveness,focusing on articles published between 2006 and 2015. The most relevant and larger scale trials were evaluated for discussion.