PV types can lead, in rare cases, to development of cervical cancer. Research has shown that for most women (90 percent), cervical HPV infection becomes undetectable within two years. Although only a small proportion of women have persistent infection, persistent infection with "high-risk" types of HPV is the main risk factor for cervical cancer.
A Pap test can detect pre-cancerous and cancerous cells on the cervix. Regular Pap testing and careful medical follow-up, with treatment if necessary, can help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into life threatening cervical cancer. The Pap test used in U.S. cervical cancer screening programs is responsible for greatly reducing deaths from cervical cancer. For 2004, the American Cancer Society estimates that about 10,520 women will develop invasive cervical cancer and about 3,900 women will die from this disease. Most women who develop invasive cervical cancer have not had regular cervical cancer screening.
How can people reduce their risk for genital HPV infection?
The surest way to eliminate risk for genital HPV infection is to refrain from any genital contact with another individual.
For those who choose to be sexually active, a long-term, mutually monogamous relationship with an uninfected partner is the strategy most likely to prevent future genital HPV infections. However, it is difficult to determine whether a partner who has been sexually active in the past is currently infected.
HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease.
On June 8, 2006, the Food and Drug Administration (FDA) licensed the first vaccine developed to prevent cervical cancer and other diseases in females caused by certain types of genital human papillomavirus (HPV). The quadrivalent vaccine, Gardasil®, protects against four HPV types (6,11,16,18), which are responsible for 70% of cervical cancers and 90% of genital warts. On June 29, 2006, the Advisory Committee on Immunization Practices (ACIP) voted to recommend use of this vaccine in females, ages 9-26 years.
This prophylactic vaccine, made from non-infectious HPV-like particles (VLP), offers a promising new approach to the prevention of HPV and associated conditions. However, this vaccine will not replace other prevention strategies since it will not work for all genital HPV types.
Provisional HPV Vaccine Recommendations
Currently, there is no test available for clinical use to determine whether a female has had any or all of the four HPV types in the vaccine.
HPV Vaccine Safety
HPV Vaccine Efficacy
Duration of Vaccine Protection
The duration of vaccine protection is unclear. Current studies (with five-year followup) indicate that the vaccine is effective for at least five years. There is no evidence of waning immunity during that time period. This information will be updated as additional data regarding duration of immunity become available.
HPV Vaccine Delivery (Provisional Recommendations)
HPV Vaccine Cost
Cost Effectiveness of HPV Vaccine
Published cost-effectiveness studies of HPV vaccination suggest that the cost per quality-adjusted life year (or QALY) saved due to vaccination against HPV types 16 and 18 would be in the $15,000 to $25,000 range per QALY. These published estimates were calculated without including the benefits of preventing HPV types 6 and 11. If such benefits were included, the cost effectiveness of vaccination would appear more favorable.
Both the impact and cost-effectiveness of HPV vaccination were estimated assuming that vaccination occurs in addition to current cervical cancer screening programs in the U.S.
Policies for HPV Vaccination
There are no federal laws requiring immunization of children with HPV vaccine. School and childcare entry laws for all immunizations are state laws and vary from state to 