Assessing the Burden of HPV-Associated Cancers in the United States HPV Prophylactic Vaccines and the Potential Prevention of Noncervical Cancers in Both Men and Women
Assessing the Burden of HPV-Associated Cancers in the United States HPV Prophylactic Vaccines and the Potential Prevention of Noncervical Cancers in Both Men and Women
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发表时间：
2008
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通讯作者：
Maura L Gillison;Anil K. Chaturvedi;Douglas R. Lowy
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作者：
Maura L Gillison;Anil K. Chaturvedi;Douglas R. Lowy
人乳头瘤病毒（HPV）是宫颈癌的必要病因。此外，在满足病毒和流行病学标准的基础上，目前普遍认为，女性肛门癌、口咽癌、外阴癌和阴道癌以及男性肛门癌、口咽癌和阴茎癌的一部分在病因学上与 HPV 有关。在这些具有病因异质性的非宫颈部位，HPV相关癌症代表了一种独特的临床病理学实体，与HPV阴性癌症相比，其一般特征是发病年龄较小、基底细胞样或疣状组织病理学、与性行为相关以及更好的预后。目前的估计表明，美国每年诊断出的 HPV 相关非宫颈癌数量大致与宫颈癌数量相当，其中男性和女性非宫颈癌数量相等。此外，虽然宫颈癌的发病率随着时间的推移一直在下降，但在美国，肛门癌和口咽癌的发病率却一直在增加，因为没有有效或广泛使用的筛查计划。因此，应评估 HPV 疫苗预防子宫颈、阴道和外阴以外部位感染的功效（例如口腔和肛门）。鉴于相当大比例的宫颈癌（约 70%）和更大比例的 HPV 相关非宫颈癌（约 86% 至 95%）是由 HPV16 和 18（当前可用疫苗针对的 HPV 类型）引起的，当前的 HPV 疫苗在减轻负担方面可能具有巨大前景（在所有相关解剖部位提供同等功效） 除宫颈癌外，还包括 HPV 相关的非宫颈癌。癌症 2008；113（10 增刊）：3036–46。美国癌症协会 2008 年出版。*梯度、一致性、实验证据和类比）。
Human papillomavirus (HPV) is a necessary cause of cervical cancer. In addition, on the basis of the fulfillment of a combination of viral as well as epidemiological criteria, it is currently accepted that a proportion of anal, oropharyngeal, vulvar, and vaginal cancers among women and anal, oropharyngeal, and penile cancers among men are etiologically related to HPV. At these noncervical sites with etiologic heterogeneity, HPV-associated cancers represent a distinct clinicopathological entity, which is generally characterized by a younger age at onset, basaloid or warty histopathology, association with sexual behavior, and better prognosis, when compared with their HPV-negative counterparts. Currently available estimates indicate that the number of HPV-associated noncervical cancers diagnosed annually in the US roughly approximates the number of cervical cancers, with an equal number of noncervical cancers among men and women. Furthermore, whereas the incidence of cervical cancers has been decreasing over time, the incidence of anal and oropharyngeal cancers, for which there are no effective or widely used screening programs, has been increasing in the US. The efficacy of HPV vaccines in preventing infection at sites other than the cervix, vagina, and vulva should, therefore, be assessed (eg, oral and anal). Given that a substantial proportion of cervical cancers (approximately 70%) and an even greater proportion of HPV-associated noncervical cancers (approximately 86% to 95%) are caused by HPV16 and 18 (HPV types that are targeted by the currently available vaccines), current HPV vaccines may hold great promise (provided equivalent efficacy at all relevant anatomic sites) in reducing the burden of HPV-associated noncervical cancers, in addition to cervical cancers. Cancer 2008;113(10 suppl):3036–46. Published 2008 by the American Cancer Society.* gradient, coherence, experimental evidence, and analogy).