Should the HPV vaccine be offered to all women?

Abstract

More than 40 genital types of HPV have been identified, of which 15 are known to be oncogenic. High risk HPV types cause all cervical cancers and true cervical pre cancer lesions, including cervical intra epithelial neoplasie III. HPV types 16 and 18 are the most common oncogenic HPV types associated with cervical cancer. HPV 16 accounts for nearly 60% of all cervical cancers, and HPV 18 accounts for another 10-20% of cervical cancers. The second most common histological type of cervical cancer, adenocarcinoma of the cervix, is becoming increasingly common in the USA. The rate of association between HPV 16 and 18 and cervical adenocarcinoma is similar, and in some populations the rate of HPV 18 exceeds that of HPV 16. HPV is also implicated in 30% of oropharyngeal cancer, 45-95% of anal cancer, 60 to 65% of vaginal cancer and 40 to 60% of vulvar cancer.