Prophylactic HPV vaccination: a major breakthrough in the fight against cervical cancer?

Cervical cancer is the second most common female cancer with 500000 new cases and 290000 deaths occurring worldwide per annum. Organized cervical screening programs have reduced the incidence and mortality of cervical cancer. However, in developing countries scarce resources, poverty, lack of infrastructure and disenfranchisement of women have been major hurdles in the effective implementation of routine screening programmes. As a result, 83% of cervical cancers still occur in the developing countries and account for 15% of all female cancers. Epidemiological studies have established a causative role of Human Papillomavi-rus (HPV) infection in the development of cervical cancer. The development and implementation of a prophylactic HPV vaccine will have a major impact on preventing this global disease. However, long-term surveillance of the HPV vaccination program will be required to confirm the expected reduction in cervical cancer incidence. This article reviews the role of HPV in the development of cancer and the burden of HPV related cancers; types and pharmacokinetics of HPV vaccines; challenges and issues in implementing vaccination programmes; screening in the developing and developed countries and screening options in the post-vaccination era.