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Prophylactic HPV Vaccines: Current Knowledge of Impact on Gynecologic Premalignancies

Abstract: Approaches for cervical cancer prevention are changing. Screening still remains the most effective method for cervical cancer prevention. Guidelines are moving to an older group of women to be screened less frequently with combinations of technologies that include biomarkers and cytology. HPV vaccination is an appropriate option for this older group of women as well, should the woman not wish to make her decision about vaccination until 21 years of age, the age of screening. Parents making decisions about HPV vaccination for their young adolescent daughters need to be fully informed that only continued screening prevents cervical cancer. HPV vaccination reduces the possibility of their daughter having an abnormal Pap test by 10% if the vaccines have not waned by the time the young adolescent becomes sexually active. HPV vaccine efficacy must last at least 15 years to contribute to the prevention of cervical cancers. At this time, protection against cervical intraepithelial neoplasia grade 2/3 (CIN 2/3) is 5 years for Gardasil and 8.4 years for Cervarix. The value of the current protection HPV vaccines offer will be viewed differently by different women. Physicians' ethical duties are to provide full explanation of the risks and benefits of adding HPV vaccination to the ongoing screening programs, and to support women in their personal choice for cervical cancer prevention. ... Read more

The Impact of Preventive HPV Vaccination

Abstract: The clearly defined causation by papillomavirus (HPV) and precursor lesions of cervical cancer have made this cancer largely preventable through Pap screening programs, and now by vaccination with Gardasil. This represents an important public health success story and here the authors summarize the potential impact of preventive HPV vaccination and some of the outstanding questions. ... Read more

Vaccine against human papillomavirus is highly effective in clinical trials

A new vaccine for human papillomavirus (HPV) has achieved 100% protection against the viral infection in young women, recently reported by a team led by Dr. Laura A. Koutsky of University of Washington, Seattle, WA and Dr. Kathrin U. Jansen of Merck Research Laboratories, Blue Bell, PA in the N. Engl. J. Med. (347:1645-1651, Nov. 21, 2002).

About 20% of adults are infected with HPV type 16 during their lifetimes. Approximately 90% of the infections resolve spontaneously and uneventfully. However some of the persistent viral infections eventually lead to cervical cancer (20 years later on average), which affects 470,000 women a ... Read more

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