CURRENT DATA ON THE EFFICACY OF PROPHYLACTIC HPV VACCINATION IN THE PRIMARY PREVENTION OF CERVICAL LESIONS

Abstract

Objective: A review of current knowledge on the efficacy of HPV vaccination against precancers and cervical cancer.

Design: Review article.

Methods and results: HPV (human papillomavirus) infection is probably the most common sexually transmitted disease and the cause of approximately 5% of all human cancers. Currently, three prophylactic vaccines against HPV infection are on the market: bivalent Cervarix, quadrivalent Gardasil (formerly Silgard) and nonavalent Gardasil9. The Czech Republic is one of the countries with a national vaccination programme where HPV vaccination is covered by health insurance for girls and boys aged 13-14 years. Extensive scientific data on the efficacy of the vaccines clearly demonstrate significant efficacy against the development of cervical precancers for all three vaccines. According to a high-certainty evidence of the Cochrane database, the efficacy of HPV vaccines against cervical intraepithelial neoplasia grade 2 or 3 associated with HPV16/18 compared with placebo in girls and women aged 15 to 26 is 99%. There is also moderate-certainty evidence that HPV vaccines reduce the risk of adenocarcinoma in situ for approximately 90 % for the same population. Initial data also demonstrate a direct impact on reducing the incidence of invasive cervical cancer in vaccinated individuals. In addition, quadrivalent and nonavalent vaccines are highly effective in preventing genital warts.

Conclusion: All three available prophylactic vaccines show high efficacy in preventing the development of cervical lesions. Efficacy is highest against lesions caused by vaccine genotypes and the highest efficacy is achieved in the HPV naive population.