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Open Access Highly Accessed Debate

Towards the eradication of HPV infection through universal specific vaccination

Piergiorgio Crosignani1, Antonella De Stefani2, Gaetano Maria Fara3, Andrea M Isidori4, Andrea Lenzi5, Carlo Antonio Liverani6, Alberto Lombardi7, Francesco Saverio Mennini1089, Giorgio Palu’11, Sergio Pecorelli12, Andrea P Peracino137*, Carlo Signorelli14 and Gian Vincenzo Zuccotti15

Author Affiliations

1 Obstetrics and Gynaecology Clinic, Università degli Studi di Milano, Milan, Italy

2 ENT Department, Ospedale Mauriziano, Turin, Italy

3 Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy

4 Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy

5 Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma, Rome, Italy

6 Preventive Gynecologic Oncology Unit - Department of Mother and Infant Sciences, Università di Milano, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

7 Fondazione Giovanni Lorenzini Medical Science Foundation, Milan, Italy

8 CEIS Sanità - Centre for Health Economics and Management (CHEM) Faculty of Economics and Faculty of Science, University of Rome “Tor Vergata”, Rome, Italy

9 Faculty of Statistics, University of Rome La Sapienza, Rome, Italy

10 Institute of Leadership and Management in Healths, Kingston University, London, UK

11 Department of Molecular Medicine, Università di Padova, Padua, Italy

12 Department of Mother and Infant Sciences and Biomedical Technologies - Rector, Università di Brescia, Brescia, Italy

13 Giovanni Lorenzini Medical Science Foundation, Houston, TX, USA

14 Department SBIBIT, Università di Parma, Parma, Italy

15 Department of Pediatrics, Università degli Studi di Milano - Luigi Sacco Hospital, Milan, Italy

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BMC Public Health 2013, 13:642  doi:10.1186/1471-2458-13-642

Published: 11 July 2013

Abstract

Background

The Human Papillomavirus (HPV) is generally recognized to be the direct cause of cervical cancer. The development of effective anti-HPV vaccines, included in the portfolio of recommended vaccinations for any given community, led to the consolidation in many countries of immunization programs to prevent HPV-related cervical cancers. In recent years, increasing evidence in epidemiology and molecular biology have supported the oncogenic role of HPV in the development of other neoplasm including condylomas and penile, anal, vulvar, vaginal, and oro-pharyngeal cancers. Men play a key role in the paradigm of HPV infection: both as patients and as part of the mechanisms of transmission. Data show they are affected almost as often as women. Moreover, no screening procedures for HPV-related disease prevention are applied in men, who fail to undergo routine medical testing by any medical specialist at all. They also do not benefit from government prevention strategies.

Discussion

A panel of experts convened to focus on scientific, medical, and economic studies, and on the achievements from health organizations’ intervention programs on the matter. One of the goals was to discuss on the critical issues emerging from the ongoing global implementation of HPV vaccination. A second goal was to identify contributions which could overcome the barriers that impede or delay effective vaccination programs whose purpose is to eradicate the HPV infection both in women and men.

Summary

The reviewed studies on the natural history of HPV infection and related diseases in women and men, the increasing experience of HPV vaccination in women, the analysis of clinical effectiveness vs economic efficacy of HPV vaccination, are even more supportive of the economic sustainability of vaccination programs both in women and men. Those achievements address increasing and needed attention to the issue of social equity in healthcare for both genders.

Keywords:
HPV infection; Condylomas; Cervical cancer; Genital cancer; Oro-pharyngeal cancer; Anti-HPV vaccines; Universal vaccination; Vaccination programs; Incremental cost-effectiveness ratio