Potential impact of a nine-valent vaccine in human papillomavirus related cervical disease
Open accessAbstract
Background: Information on human papillomavirus (HPV) type distribution is necessary to evaluate the potential impact of current and future HPV vaccines. We estimated the relative contribution (RC) to invasive cervical cancer (ICC) and precancerous cervical lesions of the nine HPV types (HPV 6/11/16/18/31/33/45/52/58) included in an HPV vaccine currently under development. Methods: Estimations on ICC were based on an international study of 8,977 HPV positive cases and estimations on precancerous cervical lesions were extracted from a published meta-analysis including 115,789 HPV positive women. Globocan 2008 and 2010 World Population Prospects were used to estimate current and future projections of new ICC cases. Results: RC of the 9 HPV types in ICC was 89.4%, with 18.5% of cases positive for HPV 31/33/45/52/58. Regional variations were observed. RCs varied by histology, ranging between 89.1% in squamous cell carcinomas (SCC) and 95.5% in adenocarcinomas (ADC). HPV 16/18/45 were detected in 94.2% of ADC. RC of the 9 types altogether decreased with age (trend test p < 0.0001), driven by the decrease in older ages of HPV 16/18/45. In contrast, the RC of HPV 31/33/52/58 increased with age. Due to population growth alone, projected estimates of ICC cases attributable to the 9 types are expected to rise from 493,770 new cases in 2012 to 560,887 new cases in 2025. The RCs of individual high risk HPV types varied by cytological and histological grades of HPV-positive precancerous cervical lesions, and there was an under representation of HPV 18 and 45 compared to ICC. Conclusions: The addition of HPV 31/33/45/52/58 to HPV types included in current vaccines could prevent almost 90% of ICC cases worldwide. If the nine-valent vaccine achieves the same degree of efficacy than previous vaccines, world incidence rates could be substantially reduced.
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About 10% of cervical cancers are due to HPV types that are not in the currently available HPV vaccines.
“about 10% of cervical cancers are due to HPV types that are not in the currently available HPV vaccines10”
From Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries (2020) · cites this paper as [10]
The Background identifies the then-current licensed vaccines as targeting HPV 16/18, which account for about 70% of cervical cancers. The Discussion says coverage would rise to almost 90% with five additional types in a nine-valent vaccine under development. The roughly 10% figure therefore applies to that proposed vaccine, not the currently available vaccines. (LLM, conf=0.92)
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Experimental — accuracy not yet measuredThe consistency of the three models' results is partly because the key drivers of predictions (achievability and timing of elimination) are country-specific baseline cervical cancer incidence and percentage of cancers due to the HPV vaccine types, which were based on the same data sources.
“Our results are consistent in part because the key drivers of our predictions (eg, achievability and timing of elimination) are country-specific baseline cervical cancer incidence and percentage of cancers due to the HPV vaccine types, which were based on the same data sources.1, 10”
From Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries (2020) · cites this paper as [10]
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Experimental — accuracy not yet measuredThe 9-valent HPV vaccine targets HPV types 16, 18, 31, 33, 45, 52, and 58, which cause about 90% of cervical cancers.
“These vaccines target high-risk HPV types that cause about 70% (bivalent and quadrivalent vaccines: HPV types 16 and 18) and 90% (9-valent vaccine: HPV types 16, 18, 31, 33, 45, 52, and 58) of cervical cancers.9, 10”
Bivalent and quadrivalent HPV vaccines target HPV types 16 and 18, which cause about 70% of cervical cancers.
“These vaccines target high-risk HPV types that cause about 70% (bivalent and quadrivalent vaccines: HPV types 16 and 18) and 90% (9-valent vaccine: HPV types 16, 18, 31, 33, 45, 52, and 58) of cervical cancers.9, 10”
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- Authors
- Serrano, B., Alemany, L., Tous, S., Bruni, L., Clifford, G. M., Weiss, T., Bosch, F. X., & de Sanjosé, S.
- Affiliations
- Institut d'Investigació Biomédica de Bellvitge (ES)
- Centre international de recherche sur le cancer (FR)
- Venue
- Infectious Agents and Cancer
- Published
- 2012-12
- Volume
- 7
- Issue
- 1
- Pages
- 38-38
- ISSN
- 1750-9378 (ISSN-L)
- PMC
- PMC3554470
- OpenAlex
- W2133525827
- Cited by
- 301
- References
- 0
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 18 · 2023: 15 · 2022: 16 · 2021: 29 · 2020: 20 · 2019: 16 · 2018: 17 · 2017: 27 · 2016: 38 · 2015: 50 · 2014: 17 · 2013: 12
- FWCI
- 18.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Infectious Agents and Cancer (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (publishedVersion, other-oa)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- GlaxoSmithKline
- Sanofi
- Sanofi Pasteur
- Agència de Gestió d'Ajuts Universitaris i de Recerca (RTIC RD06/0020/0095, RCESP C03/09, RTICESP C03/10, AGAUR 2005SGR 00695)
- Instituto de Salud Carlos III (RD06/0020, C03/09, FIS PI061246, C03/10, FIS PI030240, FIS PI061246, RCESP C03/09, RTICESP C03/10, RTIC RD06/0020/0095 and CIBERESP, PI030240, PI061246, RCESP C03/09, 051530, FIS PI030240, RTIC RD06/0020/0095, Marató de TV3, RTICESP C03/10)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Surgery › Genital Health and Disease
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- 9-valent HPV vaccine, human papillomavirus, cervical cancer, cervical precancerous lesions, HPV genotype distribution, relative contribution, HPV16, HPV 18, HPV45, cervical adenocarcinoma, cervical squamous cell carcinoma, incidence projections, vaccine impact
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