title: The Human Papillomavirus Vaccine: Current Perspective and Future Role in Prevention and Treatment of Anal Intraepithelial Neoplasia and Anal Cancer.
abstract: The incidences of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, are rising in the U.S. and globally. Five-year survival rates with current modalities of treatment for anal cancer are generally favorable for localized and regional disease. For metastatic disease, the relative survival rate is poor. Major contributing factors for the increase in anal cancer incidence include increasing receptive anal intercourse (hetero- and homosexual), increasing HPV infections, and longer life expectancy of treated people who are seropositive for human immunodeficiency virus. Because treatment outcomes with systemic therapy in patients with advanced disease are so poor, prevention may be the best approach for reducing disease burden. The association of a major causative agent with anal cancer provides an excellent opportunity for prevention and treatment. The advent of the HPV vaccine for anal cancer prevention and treatment is a significant milestone and has the potential to greatly impact these cancers. The data regarding potential use of the HPV vaccine in anal cancer prevention and treatment are reviewed.
  
  
  CONCLUSIONS
  The incidences of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, are on the rise in the U.S. and globally. Based on recent studies, the HPV vaccine is approved for prevention of the infection and development of HPV-related anal cancer. In addition, several small studies have shown that the vaccine may be useful as adjuvant therapy for anal cancer. There is a need for public health strategies aimed at education of both patients and practitioners to improve the use of the vaccine for prevention of HPV-related anal cancer. The development of a therapeutic vaccine is a work in progress.
authors.affiliation: Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA felix_mensah@hotmail.com.
authors.forename: Felix A
authors.initials: FA
authors.lastname: Mensah
authors.affiliation: Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Mudresh R
authors.initials: MR
authors.lastname: Mehta
authors.affiliation: Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.affiliation: Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: A Craig
authors.initials: AC
authors.lastname: Lockhart
mesh_terms: D001003:Anal Canal / Q000187:drug effects / Q000821:virology; D001005:Anus Neoplasms / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D002278:Carcinoma in Situ / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D015658:HIV Infections / Q000473:pathology / Q000821:virology; D006801:Humans; D027383:Papillomaviridae / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D012725:Sexual Behavior
chemical_list: D053918:Papillomavirus Vaccines
keywords: Anal intraepithelial neoplasia; Anus neoplasm; Carcinoma, squamous cell; Papillomavirus infection; Papillomavirus vaccines