Prophylactic HPV Vaccines and Prevention of Cervical Intraepithelial Neoplasia

Cervical cancer kills women of all ages. The irrefutable link to oncogenic human papillomavirus (HPV), a sexually transmitted infection, forever changed society’s attitude toward cervical cancer. The advent of HPV vaccines has brought the link of sexual practices and personal behavior to the forefront. The vaccines were aggressively marketed to parents, young girls, public health officials, physicians, and all payor sources before the scientific data defining their actual benefit could be delineated. At this early time, the HPV vaccines prevent persistent type-specific HPV infections, some abnormal Pap tests, some colposcopies, and some excisional procedures in women who are HPV-DNA negative before vaccination. Health-modeling exercises have demonstrated that duration of vaccine efficacy is the most important parameter for any long-term cancer prevention benefit. Implementation efforts have demonstrated that a three-dose series is difficult to achieve and results in a high vaccine wastage rate.