Next Generation Cancer Protection: The Bivalent HPV Vaccine for Females

Abstract

Nearly a half a million women throughout the world develop cervical cancer every year Parkin and Bray (“Chapter 2. The burden of HPVrelated cancers,” Vaccine, vol. 24, no. 3, pp. S11–S25, 2006); 80% of these women are in countries without a quality-assured cytology screening program. It is in this setting that Cervarix could reduce the incidence of cervical cancer to about 9.5/100,000 women. New evidence indicates that this might be able to be accomplished with a single dose of Cervarix, a great advantage to public health implementation programs Kreimer et al. (“Proof-of-principle evaluation of the efficacy of fewer than three doses of a bivalent HPV16/18 vaccine, The Journal of the National Cancer Institute, vol. 103, no. 19, pp. 1444–1451, 2011). In countries with screening programs, adenocarcinoma is the most difficult to detect and treat with later-stage presentation and higher mortality Smith et al. (“The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States—a 24-year population-based study,” Gynecologic Oncology, vol. 78, no. 2, pp. 97–105, 2000) and Gunnell et al. (“A longitudinal Swedish study on screening for squamous cell carcinoma and adenocarcinoma: evidence of effectiveness and overtreatment,” Cancer Epidemiology Biomarkers and Prevention, vol. 16, no. 12, pp. 2641–2648, 2007). With additional cross-protection to HPV 31, 33, and 45 and protection against HPV 16 and 18 lasting at least 9.4 years, Cervarix may reduce adenocarcinomas in screened populations by more than 90%. This paper will detail the evidence about the efficacy, immunogenicity, and safety of Cervarix in the studied populations contrasting public health goals with individual health options.

Quantifying Clinical HPV4 Dose Inefficiencies in a Safety Net Population

“…Maximizing health care resources in the near term may indicate a shift to the use of HPV2, the bivalent HPV vaccine. It has efficacy proven for both one or two doses, despite FDA labeling for three doses, lasts at least 4 years for less than three doses, and may protect against seven oncogenic HPV infections at varying efficacies [35], [46], [47] Our study showed that two doses were highly likely to be completed on-time and more likely if provided at a vaccine-only visit than at a preventive visit.…”

O câncer de colo do útero no Brasil: uma retrospectiva sobre as políticas públicas voltadas à saúde da mulher

“…No Brasil, a estimativa para o ano de 2014 publicada pelo Inca, válida também para 2015, apontou o CCU como o terceiro tipo de câncer mais incidente entre as mulheres, sendo 15.590 casos novos por ano, com um risco estimado de 15,33 casos a cada 100 mil mulheres [Ministério da Saúde (Brasil) (Harper & Vierthaler, 2011) mostrou uma taxa semelhante até os 30 anos, a princípio demonstrando equivalência de exposição aos fatores de risco. Entretanto, após essa idade, ocorre franca separação das curvas, mostrando uma incidência quase quatro vezes maior nas mulheres brasileiras em relação às britânicas aos 65 anos (Figura 3).…”

Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence

“…1B), with a first peak occurring at young ages (mean, 42.56 years) followed by a relative rebound at older ages (mean, 60.84 years). This bimodal occurrence was evoked in other population positioning peaks at younger age of 30‐34 years and slightly older age of 65‐69 years 19. These high points of cervical cancer incidence are shifted 5‐15 years after an analogous bimodal age‐specific HPV‐infection prevalence described at 25 and 45 years of age,20 which may represent the time of cervical malignant transformation to take place with some specificity of each population remnant of possible genetic and cultural differences.…”