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. 2017 Apr 11:12:19.
doi: 10.1186/s13027-017-0129-6. eCollection 2017.

Estimation of the overall burden of cancers, precancerous lesions, and genital warts attributable to 9-valent HPV vaccine types in women and men in Europe

Affiliations

Estimation of the overall burden of cancers, precancerous lesions, and genital warts attributable to 9-valent HPV vaccine types in women and men in Europe

Susanne Hartwig et al. Infect Agent Cancer. .

Abstract

Background: In addition to cervical cancer, human papillomavirus (HPV) is responsible for a significant proportion of cancers and precancerous lesions of the vulva, vagina, anus, penis, head and neck, as well as genital warts. We estimated the annual number of new cases of these diseases attributable to 9-valent HPV vaccine types in women and men in Europe.

Methods: The annual number of new cancers of the cervix, vulva, vagina, anus, penis, and selected head and neck sites in the population of the European Medicines Agency territory was estimated based on age-specific incidence rates extracted from Cancer Incidence in 5 Continents, Volume X and Eurostat population data for 2015. The annual number of new cancers attributable to 9-valent HPV vaccine types was estimated by applying the HPV attributable fraction from reference publications based on a large European multicenter study. For non-cervical cancers, HPV attributable fractions were based on oncogenically-active HPV infections only (i.e., detection of HPV DNA and either mRNA and/or p16 positivity). For precancerous lesions of the cervix, vulva, vagina, and anus, and for genital warts, previously published estimations were updated for the 2015 population.

Results: The annual number of new cancers attributable to 9-valent HPV vaccine types was estimated at 47,992 (95% bound: 39,785-58,511). Cervical cancer showed the highest burden (31,130 cases), followed by head and neck cancer (6,786 cases), anal cancer (6,137 cases), vulvar cancer (1,466 cases), vaginal cancer (1,360 cases), and penile cancer (1,113 cases). About 81% were estimated to occur in women and 19% in men. The annual number of new precancerous lesions (CIN2+, VIN2/3, VaIN2/3, and AIN2/3) and genital warts attributable to 9-valent HPV vaccine types was estimated at 232,103 to 442,347 and 680,344 to 844,391, respectively.

Conclusions: The burden of cancers associated with 9-valent HPV vaccine types in Europe is substantial in both sexes. Head and neck cancers constitute a heavy burden, particularly in men. Overall, about 90% of HPV-related cancers, 80% of precancerous lesions, and 90% of genital warts are expected to be attributable to 9-valent HPV vaccine types each year, demonstrating the important preventive potential of the 9-valent HPV vaccine in Europe.

Keywords: Burden of disease; Cancer; Genital warts; Head and neck; Human papillomavirus; Precancerous lesions.

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Figures

Fig. 1
Fig. 1
Overall burden of diseases attributable to the 9-valent HPV vaccine types in men and women in Europe. CIN2+: cervical intraepithelial neoplasia grade 2 or worse; VIN2/3: vulvar intraepithelial neoplasia grades 2 and 3; VaIN2/3: vaginal intraepithelial neoplasia grades 2 and 3; AIN2/3: anal intraepithelial neoplasia grades 2 and 3

Comment in

  • HPV: "Früh impfen bringt viel".
    Bauer E. Bauer E. MMW Fortschr Med. 2023 Apr;165(8):58. doi: 10.1007/s15006-023-2569-9. MMW Fortschr Med. 2023. PMID: 37081360 German. No abstract available.

References

    1. Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372:711–723. doi: 10.1056/NEJMoa1405044. - DOI - PubMed
    1. National Institutes of Health, National Cancer Institute. Gardasil 9 Vaccine Protects against Additional HPV Types. https://www.cancer.gov/types/cervical/research/gardasil9-prevents-more-H.... Accessed 30 Nov 2016
    1. Vichnin M, Bonanni P, Klein NP, Garland SM, Block SL, Kjaer SK, et al. An overview of quadrivalent human papillomavirus vaccine safety: 2006 to 2015. Pediatr Infect Dis J. 2015;34:983–991. doi: 10.1097/INF.0000000000000793. - DOI - PubMed
    1. European Medicines Agency. Annexe I. Summary of Product Characteristics. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Info.... Accessed 30 Nov 2016.
    1. Hartwig S, Baldauf JJ, Dominiak-Felden G, Simondon F, Alemany L, de Sanjose S, et al. Estimation of the epidemiological burden of HPV-related anogenital cancers, precancerous lesions, and genital warts in women and men in Europe: potential additional benefit of a nine-valent second generation HPV vaccine compared to first generation HPV vaccines. Papillomavirus Res. 2015;1:90–100. doi: 10.1016/j.pvr.2015.06.003. - DOI