[Human papillomavirus and carcinoma of the cervix vaccines against the human papillomavirus-promise of an efficacious prevention].
The persistent infection with high-risk (oncogenic) HPV types is the necessary cause of cervical cancer. HPV types 16 and 18 are the most important of the high-risk types all around the world. The low risk HPV types, include type 6, 11 and next, cause either benign genital warts or low-grade intraepithelial lesions. Cervical cancer is the third most important cause of cancer deaths in women worldwide, after, first, breast cancer and, second, lung cancer, and the leading cause of cancer deaths in women in the developing world. Every year, half a million women around the world are diagnosed as new cases, and more than 270,000 die from this disease. The majority of deaths, around 80 %, occur in developing countries (in Latin America and Sub-Saharan Africa). The main reason for these variations in incidence is probably the availability of screening programmes in many developed countries but not in poorer developing countries. Pap smear testing forms the basis of cervical cancer screening programmes round the world. A well-implemented screening programme can reduce the incidence of cervical cancer in a country by approximately 80 %. Although useful is fully implemented, a cytology-based screening programme does have limitations. It cannot prevent infection with high-risk HPV or the subsequent development of pre-cancerous lesions. It is also a very expensive and demanding system to set up and maintain. Knowledge that cervical cancer is caused by viral infection provided the exceptional way to use a vaccination as the next tool of cervical cancer prevention. There are the only two realistic approaches for the prevention of cervical cancer--cervical screening and vaccination. Vaccination of a healthy individual to protect them against a disease is an excellent example of primary prevention. Two pharmaceutical companies--GlaxoSmithKline (GSK) and Merck--developed a prophylactic vaccines which are already in the pre-licence phase. The results published up to now showed a high efficacy and good safety profile of vaccines, and were well tolerated.
Kohl
Igor
I
Department Vaccines Biologicals, GlaxoSmithKline Prague, Czech Republic. igor.i.kohl@gsk.com
D005260:Female; D052162:Human papillomavirus 16 / Q000276:immunology*; D052161:Human papillomavirus 18 / Q000276:immunology*; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology