How Can We Pursue Equity in Cervical Cancer Prevention with Existing HPV Genotype Differences?
Menée à partir des données de septs études américaines, cette étude analyse, en fonction de l'origine ethnique, la proportion de patientes présentant une néoplasie cervicale intraépithéliale de grade 3 ou un carcinome épidermoïde ayant pour origine un papillomavirus humain dont le type est ciblé par le vaccin nonavalent
Persistent infection with high-risk human papillomavirus (HPV) is the cause of most cervical cancers [1, 2]. Over the past decades there has been significant progress in primary and secondary prevention of cervical cancer through HPV vaccination and screening. The first HPV vaccines approved for use in the United States (US) targeted the most common oncogenic genotypes, HPV16 and HPV18 [3, 4], which are responsible for up to 71% of cervical cancers[5]. In 2014, the Food and Drug Administration licensed the 9-valent HPV vaccine, which added protection against 5 additional oncogenic genotypes (31, 33, 45, 52, 58) responsible for approximately 15% of cervical cancers [6]. The current guideline from the Advisory Committee on Immunization Practices recommends routine HPV vaccination for males and females between ages 9-26 [6]. In addition to randomized trials demonstrating the efficacy of the 9-valent vaccine in preventing HPV infection and cervical dysplasia [7, 8], observational studies have demonstrated the real-world effectiveness of HPV vaccines in preventing cervical cancer [9-11]. Despite this encouraging evidence, several studies have demonstrated racial and ethnic differences in HPV genotypes [12-14], raising concerns about HPV vaccination equity.