Vaccination of children and teenagers to prevent cervical cancer

In Europe, 15,000 women die from cervical cancer each year. In Ireland, it results in around 180 new cases and 80 deaths every year. Human papillomaviruses (HPVs) play a key role in this cancer’s aetiology. Recently, effective vaccines have been developed against HPV, which raises the possibility of preventing cervical cancer. This review examines the evidence both for and against the vaccination of children and teenagers for HPV to protect against cervical cancer. Randomised controlled trials of HPV vaccines have demonstrated their immunogenicity, and ability to prevent incident and persistent type-specific HPV infection, and the associated cytological abnormalities of the cervix. Vaccination of children and teenagers remains controversial, as the long-term impact of these vaccines remains unknown. Important ethical issues have also emerged around the prospect of mandatory vaccination programmes. However, most gynaecologic oncologists have embraced this step as a proven preventive strategy. Further well-designed studies of vaccines are needed to guide clinicians’ decision-making.