Table 1.

HPV-related disease and roles for screening and vaccination in the developing versus industrialized world

Existing interventionPotential for intervention
Disease burdenaScreeningHPV vaccineScreeningHPV vaccine
Developing world
 CervicalHighLimitedLimitedHighHighb
 Noncervicalc
  OropharyngealLowNoneLimiteddNoneLowe
  OtherLowNoneLimitedNoneLowe
 Noncervical (male)
  OropharyngealLowNoneLimiteddNoneLowe
  OtherLowNoneLimitedNoneLowe
Industrialized world
 CervicalHighExtensiveExtensivefHighHigh
 Noncervicalc
  OropharyngealHighNonegExtensivedNonegHighd
  OtherModerateLimitedExtensiveUnknownhModeratei
 Noncervical (male)
  OropharyngealHighNonegLimiteddNonegHighd
  OtherModerateLimitedLimitedUnknownhModeratei

iAlthough the vaccine should be highly effective against the HPV types associated with these diseases, the relative population-wide impact of reducing them would be “moderate.”

  • aThough high worldwide, the incidence of cervical cancer is substantially higher in the developing than industrialized world. Noncervical disease burdens are relative to cervical cancer in the developing or industrialized world.

  • bCurrently being developed by the GAVI Alliance and other potential donors.

  • cIncludes males and females.

  • dAlthough the vaccine should be highly effective against the HPV types associated with this disease, there are no vaccine data on oral/oropharyngeal infection or disease.

  • eAlthough the vaccine may be effective against these diseases, their currently low prevalence would limit the potential population-wide impact of vaccine.

  • fThe extent of vaccine uptake in the U.S. lags behind other industrialized countries. Therefore, in October 2011 the U.S. CDC ACIP upgraded its male vaccine recommendation to “routine.” For countries with high HPV vaccine uptake among females, herd immunity from female vaccination should protect most males from HPV-associated disease.

  • gNo established screening for oropharyngeal HPV or its related neoplasia is currently available.

  • hNo established screening for anal cancer, but it is under consideration for high-risk populations.