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A Strategy Built on Shared Values May Help Boost HPV Vaccination Rate

Maurie Markman, MD
Published: Tuesday, Dec 04, 2018
Maurie Markman, MD

Maurie Markman, MD
If vaccination against the human papillomavirus (HPV) were being ranked on a scale of 1 to 100 in terms of level of evidence for the safety, efficacy, and potential to substantially impact the risk of developing and the cost of treating malignant disease, it must be scored at 110—if not higher—as an approach to cancer prevention.1

The well-documented clinical utility of HPV vaccination has been revealed through definitive knowledge of the virus as a major causative agent in the development of a number of malignancies, such as cervix, vulvar, anal, penile, and oropharyngeal cancers. The results of multiple high-quality phase III randomized trials in cervix cancer confirm the vaccine’s safety and efficacy, supported by findings from population-based observational studies following the implementation of a vaccination strategy.1,2 Of note, the percentage of high-risk HPV type 16 and 18 responsible for HPV-associated noncervical cancers (86% to 95%) is even greater than it is for cervix cancer (70%), leading to the highly rational conclusion that vaccination against these strains with commercially available vaccines will be as effective, if not more effective, in preventing these malignancies in noncervical cancers as it is in cervix cancer.3 Finally, although the prevalence of HPV within the adult population in the United States ranges between 40% to 45%, and high-risk HPV prevalence ranges between 20% to 25%,4 early studies have confirmed a striking decrease in the population-based prevalence of HPV following implementation of an HPV vaccination strategy.5

However, the continued inability of the combined efforts of the public health and medical communities to present a compelling argument to ensure near-universal HPV vaccination must reasonably be considered, as of this date, to be distressing.1 In 2017, available data indicate that less than half (43.4%) of eligible adolescents were up-to-date for receipt of the HPV vaccine series, which was only slightly improved (+2.2%) from the preceding year.6

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