2. Division of Population Health Sciences, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, UK.
Background: The role of Human Papillomavirus (HPV) in cervix cancers is well established with immunisation commenced in most developed countries. The role of HPV in uterine cervix cancers is well established with immunisation programmes commenced in most developed countries. Despite numerous publications on HPV association with cancers affecting multiple body sites, there is substantial amount of controversy over HPV immunisation as a preventive measure. The aim of this study was to establish the evidence for HPV-associated cancers in regions other than the cervix and question whether the evidence would support a global immunisation programme against HPV irrespective of gender or geography.
Methods: A systematic review of previous studies. Searching MEDLINE (1962-April 2011), Embase (1988-April 2011), and Cochrane Library (to April 2011) identified published articles.
Results: 651 of 13,090 identified studies were eligible for inclusion. The overall median prevalence of HPV in cancers was 31%. This varied considerably by cancer type with the median prevalence for bladder cancer (12%), compared to that for anal/colorectal cancers (61.5%). Upper aerodigestive and gastrointestinal tract cancers had the largest number of studies and reported median prevalence of 33.3% and 30.1%, respectively.
Conclusions: Our assessment that 1 in 3 cancers are HPV-associated can be interpolated to 2.12 million cancers annually worldwide. If we were to not consider HPV-associated cancer as a disease of single anatomical subsites, but to consider it as a disease of the entire human body the current available evidence on incidence may support a global immunisation programme.
Keywords: Human papillomavirus, cancer, immunisation, cervix