HPV is a necessary condition for cervical cancer, which is the fourth most common cancer in women, with an estimated 266,000 deaths and 528,000 new cases worldwide in 2012. A large majority (around 85%) of the global burden occurs in the less developed regions, where it accounts for almost 12% of all female cancers.
HPV is the most common viral infection of the reproductive tract. Although most HPV infections cause no symptoms, persistent genital HPV infection can cause cervical cancer in women. HPV can also cause other types of anogenital cancers, head and neck cancers, and genital warts in both men and women. HPV infections are transmitted through sexual contact. More information on HPV can be found on the WHO website.
Several vaccines that prevent HPV infection are now available in many countries throughout the world. These include a bivalent, a quadrivalent and a nonavalent vaccine. All three vaccines are highly efficacious in preventing infection with virus types 16 and 18, which are together responsible for approximately 70% of cervical cancer cases globally. The nonavalent vaccine also prevents types 31, 33, 45, 52 and 58 which also cause some cases of cervical cancer. The vaccines are also highly efficacious in preventing precancerous cervical lesions caused by these virus types. The quadrivalent and nonvalent vaccines are also highly efficacious in preventing anogenital warts, a common genital disease which is usually caused by infection with HPV types 6 and 11. Data from clinical trials and initial post-marketing surveillance conducted in several continents show all three vaccines to be safe.
The WHO recommends giving two doses of the bivalent vaccine, or two to three doses of the quadrivalent vaccine, to girls aged 9 to 13 years old. More information can be found in the WHO position paper. Consideration of cost-effectiveness is recommended. For countries without the capacity to develop their own cost-effectiveness models, PRIME is offered as a simple economic model which can support evidence-based decision-making.