Towards the elimination of cervical cancer: HPV epidemiology, real-world experiences and the potential impact of the 9-valent HPV vaccine

Objectives: This review aims to describe the biology of human papillomavirus (HPV), the development of the related vaccine, real-life experiences from the perspective of the WHO's call on the elimination of cervical cancer, the vaccine's use as an adjuvant to treatments for HPV-related disease, and the international scientific societies' guidelines on HPV vaccination. A systematic review was conducted, also for the specific purpose of assessing the efficacy, immunogenicity and safety of the 9-valent HPV vaccine (the latest to become available). Data sources and study selection methods: PubMed was the primary source of data for this review, while additional information, such as scientific society guidelines, was found by directly searching the web. Publications were eligible if they had at least one result relating to the immunogenicity, safety and efficacy or effectiveness of HPV vaccines. Tabulation, integration and results: The search in the database for this systematic review yielded 266 records, none of which was a duplicate. A first screening procedure excluded 228 publications. Of the remaining 38 potentially eligible publications, 26 were ultimately included in the systematic review. Conclusion: While progress in vaccine development has added more tools to HPV vaccination programs, real-word studies have started to show the benefits of mass vaccination campaigns using bivalent and quadrivalent vaccines. National vaccination programs have also been a testing ground for gender-neutral vaccination—a strategy on which unanimous consensus may not still be lacking, but which undeniably responds to clinical and ethical needs. Much the same can be said of post-treatment vaccination—a relatively new, but promising practice that will certainly have a role in achieving the elimination of cervical cancer