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Prophylactic human papillomavirus vaccines: the beginning of the end of cervical cancer
  1. W. A. A. Tjalma*,
  2. M. Arbyn,
  3. J. Paavonen,
  4. T. R. Van Waes* and
  5. J. J. Bogers§
  1. * Department of Gynecology and Gynecologic Oncology, University Hospital Antwerp, University Antwerp, Antwerp, Belgium
  2. Unit of Cancer Screening, Department of Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
  3. Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
  4. § Department of Surgical Pathology and Histology, University Hospital Antwerp, University Antwerp, Antwerp, Belgium
  1. Address correspondence and reprint requests to: Prof Wiebren A. A. Tjalma, MD, PhD, Department of Gynecology and Gynecological Oncology, University Hospital Antwerp, University Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium. Email: wiebren.tjalma{at}uza.be

Abstract

Persistent infection with one of the oncogenic human papillomavirus (HPV) types is a necessity for the development of cervical cancer. By HPV vaccination, cervical cancer could become a very rare disease. Two types of HPV vaccines can be distinguished: (i) therapeutic vaccines which induce cellular immunity targeted against epithelial cells infected with HPV and (ii) prophylactic vaccines inducing virus-neutralizing antibodies protecting against new but not against established infections. At present, several vaccines have been developed and tested in clinical trials. The vaccines are generally well tolerated and highly immunogenic. The current clinical data indicate that prophylactic vaccines are very effective against new persistent infections and the development of cervical intraepithelial lesions. The protection is type specific. However, the follow-up of the vaccination trials is still short. The effect of HPV vaccines on future cancer incidence will only be known after decades of follow-up. This article will address the status of recently terminated phase II and currently running phase III trials with prophylactic HPV vaccines.

  • cervical cancer
  • cervical neoplasia
  • human papillomavirus
  • primary prevention
  • prophylactic vaccines
  • screening
  • vaccination

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