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REVIEW

Cancers attributable to human papillomavirus infection

Andrew E. Grulich A E , Fengyi Jin A B , E. Lynne Conway C , Alicia N. Stein C and Jane Hocking D
+ Author Affiliations
- Author Affiliations

A HIV Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2021, Australia.

B Sexually Transmitted Infections Research Centre, University of Sydney, NSW 2006, Australia.

C CSL Limited, Parkville, Vic. 3052, Australia.

D School of Population Health, University of Melbourne, Carlton, Vic. 2010, Australia.

E Corresponding author. Email: agrulich@nchecr.unsw.edu.au

Sexual Health 7(3) 244-252 https://doi.org/10.1071/SH10020
Submitted: 18 February 2010  Accepted: 19 April 2010   Published: 19 August 2010

Abstract

Although the human papillomavirus (HPV) vaccine was introduced primarily as a cervical cancer prevention vaccine, HPV has a causal role in several types of cancer. This article reviews the epidemiological evidence for the role of HPV in human cancer, and describes Australian trends in these cancers. HPV is a necessary cause of cervical cancer. The currently vaccine-preventable subtypes of HPV 16 and 18 are responsible for ~70% of cervical cancer. The introduction of an organised Pap smear program in Australia led to a steep decline in incidence over the past decades. HPV can be detected in ~40% and 70% of vulval and vaginal cancers respectively. Rates of these cancers have been stable over the past 20 years. The prevalence of HPV in penile cancer is ~50% and incidence has not recently changed. For anal cancer, ~85% of cases are HPV positive, and incidence has increased significantly in both men and women over the past 20 years. In the oral cavity, ~35% of oropharyngeal cancers and ~25% of other oral cavity cancers are HPV positive. The incidence of HPV-related oral cavity and oropharyngeal cancers is increasing, whereas incidence at HPV-unrelated sites is decreasing. Overall, 1154 HPV-related cancer cases were potentially preventable by vaccination. If HPV-related cancers at non-cervical sites are prevented by vaccination, then a similar number of cancer cases will be prevented as in the cervix. However, almost one-quarter of the potentially preventable cancer cases are in men, who are not included in the current national immunisation program.

Additional keywords: Australia, cervical cancer, HPV vaccine.


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