HPV vaccination around the world. The programmes, the coverage and the challenges Europe and the Caucasus

Dr. Diana Valuta XII INTERNATIONAL WORKSHOP OF LOWER GENITAL TRACT PATHOLOGY 5-7 March 2015

HPV infection/CANCER

Human papillomaviruses (HPVs) cause cancer at multiple anatomic sites in men and women, 2008 - 610 000 new cases of HPV-related cancer worldwid – 4,8% from all new cases WOMEN CANCER MEN CANCER 570,000 new cases (PAF, 9,4%) 39,000 new cases (PAF, 0,6%) CERVICAL 100%

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VULVAR 70%

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VAGINAL ≤43%

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OROPHARYNGEAL 50% + tabaco

OROPHARINGEAL 50% + tabaco

ANAL 88%

ANAL 88%

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PENILE 50%

Proportion of total cancer cases attributable to HPV by geographical region/country on female Female % 30 25 20 15 10 5

Female %

0

EUROGIN 2014 roadmap

Proportion of total cancer cases attributable to HPV by geographical region/country on male 2 1,8 1,6 1,4 1,2 1 0,8 0,6 0,4 0,2 0

Male %

EUROGIN 2014 roadmap

CERVICAL CANCER / HPV INFECTION

Worldwide, more HPV-related cancers are diagnosed among women compared to men, primarily owing to the large burden of cervical cancer.

HPV INFECTION AND CERVICAL CANCER • HPV is an extremely common sexually transmitted infection • HPV can produce the abnormal cervical cells found on Pap test • In case when HPV infection persist the abnormal cervical cells can progress to cervical cancer. • Cervical cancer will not develop in the absence of HPV infection • HPV vaccine can prevent HPV infection and protect against the cervical cancers • the 2 most common high-risk types of HPV types 16 & 18, which cause about 2/3 of cervical cancers and many cases of abnormal cervical cells

Evolution of the HPV/Cervical cancer • The proportion of high-risk (HR) and low-risk (LR) HPV infections in women appears equivalent (HR, 14–15%; LR,1–5 18%); Years 5–10+ Years HPV Infection

LSIL-HSIL