• 8/12/2004
  • New York, NY
  • By Will Boggs, MD
  • Reuters Health

An effective vaccine based on seven human papillomavirus (HPV) types could prevent most cervical cancers worldwide, according to a report in the August 20th International Journal of Cancer.

“HPV vaccines offer today the best strategy to combat cervical cancer,” Dr. Nubia Muñoz from International Agency for Research on Cancer, Lyon, France told Reuters Health.

Dr. Muñoz and colleagues conducted a pooled analysis of all HPV types in cervical cancer from an international survey and from a multicenter case-control study, involving more than 3600 women with histologically confirmed cervical cancer from 25 countries.

Overall, the HPV DNA prevalence was 92.5%, the authors report, ranging from 83.6% of squamous cell carcinomas in Europe/North America to 96.5% of squamous cell carcinomas in south Asia, and from 93.3% of adenocarcinomas in south Asia to 100% of adenocarcinomas in sub-Saharan Africa and Europe/North America.

HPV genotypes 16 and 18 accounted for most of the cases in each region of the world, including 63.9% in sub-Saharan Africa, 78.9% in northern Africa, 65.0% in Central/South America, 73.5% in south Asia, 71.5% in Europe/North America, and 70.7% overall.

Seven genotypes (HPV 16, 18, 45, 31, 33, 52, and 58) accounted for 87.4% of all cervical cancer cases worldwide, with little regional variation, the researchers note.

“Generating a vaccine with seven HPV types would be technically feasible,” the investigators conclude. “However, the production cost may be high, and the protection conferred by the less common HPV types may be difficult to demonstrate clearly.”

“Considering that cost might be most limiting to developing countries, a vaccine containing the two (HPV 16 and 18) or three (HPV 16, 18, and 45) most common types, which could be less expensive, might be more realistic,” Dr. Muñoz said.

“Vaccinating against HPV 16 and 18 while waiting for vaccines containing more types makes a lot of sense, because 70% of cervical cancers could be prevented,” Dr. Muñoz concluded. “This is much more than the prevention achieved by badly conducted screening programs which are currently implemented in some developing countries.

SOURCE: International Journal of Cancer 2004;111:278-285.