Human papillomavirus (HPV) vaccination: a call for action in Italy

Bogani, Giorgio; Ghelardi, Alessandro; Sopracordevole, Francesco; Annoni, Marco; Ciavattini, Andrea; Giannella, Luca; Vincenzo, Rosa De; Cattani, Paolo; Barbero, Maggiorino; Vercellini, Paolo; Raspagliesi, Francesco; Bonanni, Paolo; Scambia, Giovanni

doi:10.1136/ijgc-2023-004275

Cited by 12 publications

(8 citation statements)

References 43 publications

(127 reference statements)

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“…Fourth, only a minority of patients included in this study received adjuvant vaccination. Although we are expecting a limited effect of HPV vaccination in this cluster of patients, growing evidence supports the adoption of vaccination after primary treatment (Bogani et al ., 2021a, 2023; Di Donato et al ., 2022). Even in our series, we observed that patients receiving vaccination were at a lower (but not statistically significant) risk of developing HSIL/CIN2+ recurrence in comparison to those who had not.…”

Section: Discussionmentioning

confidence: 99%

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Bogani

Sopracordevole

Ciavattini

et al. 2023

European Journal of Cancer Prevention

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Objective To evaluate how the duration of human papillomavirus (HPV) persistence influences the risk of developing recurrent high-grade cervical dysplasia (CIN2+). Methods Data of patients with persistent HPV infection (at least at 6 months) after primary conization were extracted from a multi-institutional Italian database, retrospectively. Kaplan–Meier and Cox proportional hazards models were used to evaluate associations between duration of HPV persistence with the 5-year risk of developing recurrent CIN2+. Results Overall, 545 patients met the inclusion criteria. Positive margins were detected in 160 (29.3%) patients. Overall, 247 (45.3%) and 123 (22.6%) patients had a documented infection from HPV16/18, and other high-risk HPV types. 187 (34.3%), 73 (13.4%), and 40 (7.3%) were diagnosed with persistent HPV infection at 12, 18, and 24 months, respectively. Patients with HPV persistence at 6 months experienced a risk of recurrence of 7.46%. Twelve-month HPV persistence strongly correlates with the risk of developing the recurrent disease (risk of recurrence: 13.1%). While, having HPV persistence >12 months did not correlate with an increased risk of recurrence (hazard ratio: 1.34 (95% confidence interval: 0.78–2.32); P = 0.336, log-rank test). Conclusion HPV persistence is one of the most important factors predicting the risk of CIN2+ recurrence. The risk of CIN2+ recurrence increased with the increase of HPV persistence for up to 1 year. The persistence of HPV after the first year does not appear as a risk factor.

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Section: Discussionmentioning

confidence: 99%

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Bogani

Sopracordevole

Ciavattini

et al. 2023

European Journal of Cancer Prevention

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“…The implementation of primary prevention aims to reduce the burden of HPV infection and HPV-related disease [ 89 ]. There are five approved HPV vaccines, three of them in Europe, which prophylactically prevent HPV infection, despite each of them targeting different strains [ 90 ].…”

Section: Vaccination Prophylaxis and Cancer Preventionmentioning

confidence: 99%

“…There are five approved HPV vaccines, three of them in Europe, which prophylactically prevent HPV infection, despite each of them targeting different strains [ 90 ]. With more than 200 million doses administered to date, HPV vaccines are considered to be safe and effective in preventing HPV-related infections and cancers [ 89 ]. Therefore, in 2020, the FDA in the United States and the EMA in Europe extended the use of HPV vaccines to males [ 91 ].…”

Section: Vaccination Prophylaxis and Cancer Preventionmentioning

confidence: 99%

Analogies between HPV Behavior in Oral and Vaginal Cavity: Narrative Review on the Current Evidence in the Literature

Dellino,

Pinto,

D’Amato

et al. 2024

JCM

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Human genital papilloma virus infection is the most prevalent sexually transmitted infection in the world. It is estimated that more than 75% of sexually active women contract this infection in their lifetime. In 80% of young women, there is the clearance of the virus within 18–24 months. In developed countries, oral squamous cell carcinoma (OSCC) is now the most frequent human papilloma virus (HPV)-related cancer, having surpassed cervical cancer, and it is predicted that by 2030 most squamous cell carcinomas will be the HPV-related rather than non-HPV-related form. However, there are currently no screening programs for oral cavity infection. While the natural history of HPV infection in the cervix is well known, in the oropharynx, it is not entirely clear. Furthermore, the prevalence of HPV in the oropharynx is unknown. Published studies have found wide-ranging prevalence estimates of 2.6% to 50%. There are also conflicting results regarding the percentage of women presenting the same type of HPV at two mucosal sites, ranging from 0 to 60%. Additionally, the question arises as to whether oral infection can develop from genital HPV infection, through oral and genital contact or by self-inoculation, or whether it should be considered an independent event. However, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. Therefore, this literature review aims to evaluate whether there is evidence of a connection between oral and cervical HPV, while also endorsing the usefulness of the screening of oral infection in patients with high-risk cervical HPV as a means of facilitating the diagnosis and early management of HPV-related oral lesions. Finally, this review emphasizes the recommendation for the use of the HPV vaccines in primary prevention in the male and female population as the most effective means of successfully counteracting the increasing incidence of OSCC to date.

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“…Since the decade 2010-2019, several countries have extended vaccination to boys of the same age, and more will follow (42). Despite the availability of a vaccine, the percentage of HPV-vaccinated girls still varies significantly across countries, ranging from 99% in Malta to 3% in Bulgaria, according to the latest updated and has yet to be fully addressed (44,45). Despite the improvements achieved in the individual cohorts, the average HPV vaccination coverage rate in girls and boys is still far from the expected optimal threshold envisaged by the Italian national vaccination prevention plan (i.e., 95% at age 12), and there is an obvious problem of inequality between regions as recently highlighted (45,46).…”

Section: Vaccination Against Hpvmentioning

confidence: 99%

Sexually transmitted infections and the HPV-related burden: evolution of Italian epidemiology and policy

Gazzetta,

Valent,

Sala

et al. 2024

Front. Public Health

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Sexually transmitted infections (STIs) are a major public health problem worldwide, with a high prevalence between the ages of 15 and 25 in most Western countries. High notification rates of chlamydia, gonorrhea, and syphilis are reported in the WHO European Region, with differences between countries. In Italy, the total number of STIs alerts increased by 18% from 2020 to 2021. HPV is the most common sexually transmitted infection; globally one in seven women is infected by this virus, and certain sexual behaviors are important risk factors for HPV-related cancers, particularly cervical cancer (CC), anogenital cancers and cancers of the head and neck. The burden of CC is relevant worldwide, in particular in Europe CC is the third leading cause of cancer-related deaths in women aged 15–44. This HPV-related tumor is preventable through a combined strategy of vaccination and screening for precursor lesions. In Italy, the coverage of organized screening varies from region to region and the average HPV vaccination rate is still far from the expected optimal threshold of 95% at the age of 12. To address the challenges of health promotion and HPV prevention, priority actions are needed such as: promoting education and information at every level, from schools to healthcare professionals. In Italy, education of adolescents on sexual and reproductive health, still remains critical, regionally inhomogeneous and much lower than in other European countries. Equitable measures need to be taken, and schools are an important place for health promotion activities.

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Human papillomavirus (HPV) vaccination: a call for action in Italy

Cited by 12 publications

References 43 publications

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Analogies between HPV Behavior in Oral and Vaginal Cavity: Narrative Review on the Current Evidence in the Literature

Sexually transmitted infections and the HPV-related burden: evolution of Italian epidemiology and policy

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