Kaiser Family Foundation

HPV Vaccines and Cancer in the U.S.

Kaiser Family Foundation

HPV, Cancer, and Screening

Akers, A.Y., S.J. Newmann, and J.S. Smith. May/June 2007. Factors Underlying Disparities in Cervical Cancer Incidence, Screening, and Treatment in the United States. Current Problems in Cancer 31(3): 157-181.
This article examines the prevalence of cervical cancer among various racial and ethnic groups in the United States, as well as the access to prevention and treatment.


Anic, G.M., and A.R. Guiliano. October 2011. Genital HPV Infection and Related Lesions in Men. Preventive Medicine 53(S1): S36-S41.
This article exmines the prevalence of HPV related infections and cancers in Men and discusses use of the vaccine.


Bradley, C.J., C.W. Given, and C. Roberts. December 2004. Health Care Disparities and Cervical Cancer. American Journal of Public Health 94(12): 2098-2103.
This study compares cervical cancer incidence and survival rates between Medicaid insured and non-Medicaid insured populations.


Chaturvedi, A.K., E.A. Engels, R.M. Pfeiffer, et al. October 2011. Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States. Journal of Clinical Oncology Epub.
Examines the rise in oral cancers related to HPV.


De Sanjose, S., M. Diza, X. Castellsaque, et al. July 2007. Worldwide Prevalence and Genotype Distribution of Cervical Human Papillomavirus DNA in Women with Normal Cytology: A Meta-Analysis. The Lancet 7(7):453-459.
This study provides an estimate of age and genotype-specific prevalence of HPV DNA in women worldwide by meta-analysis of a literature review. It estimates that around 291 million women worldwide are carriers of HPV DNA, with prevalence highest in women younger than 35 years.


Harper, DM. September 2008. Impact of vaccination with Cervarix on subsequent HPV-16/18 infection and cervical disease in women 15-25 years of age. Gynecology Oncology 110(3).
This report discusses the predominant types of HPV infections, 16 and 18, and the impact of vaccination given to girls and women reduces the risk of cervical cancer.


Katz, I.T. and A.A. Wright. March 2006. Preventing cervical cancer in the developing world. The New England Journal of Medicine 354(11):1110
This article discusses the use of the Pap smear to prevent death from cervical cancer. The study presents data from developing countries where low-cost techniques have been developed to identify and treat abnormal cervical lesions in a single visit.


Lee, J.W., Z, Berkowitz, and M. Saraiya. July 2011. Low-Risk Human Papillomavirus Testing and Other Nonrecommended Human Papillomavirus Testing Practices Among U.S. Health Care Providers. Obstetrics & Gynecology 118(1): 4-13.
This study examines self-reported HPV testing practices by health care providers and clinics, including nonrecommended practices such as low-risk HPV testing, HPV contesting in women younger than age 30, and HPV reflex testing for high-grade abnormal Pap test results.


Mandelblatt, J.S., W.F. Lawrence, S.M. Womack, et al. 2002. Benefits and costs of using HPV testing to screen for cervical cancer. The Journal of the American Medical Association 287:2372–2381.
This study compares the societal costs and benefits of HPV testing, Pap testing, and a combination of the two tests to screen for cervical cancer.


Markowitz, L. 2007. HPV Vaccines – Prophylactic, Not Therapeutic. Journal of the American Medical Association. 298:805-806.
This article discusses the role of the HPV vaccine in prevention as opposed to treatment.


Marsk, J.S. and N.C. Lee. March 2000. Implementing recommendations for the early detection of breast and cervical cancer among low-income women. The Centers for Disease Control and Prevention
This report explains breast and cervical cancer incidence and prevention methods. With regard to cervical cancer, the authors note that early detection of precancerous lesions through the use of a Pap test can effectively control cervical cancer, especially in low-income groups, if screenings are made more easily accessible.


Rositch, A.F. et al. November 2011. Multiple Human Papillomavirus Infections and Type Competition in Men.  The Journal of Infectious Diseases: doi:10.1093/infdis/jir709.
This study examines HPV type competition in men and whether the vaccine increases prevalence and competition of other HPV types.


Techakehakij, W. and R.D. Feldman. November 2008. Cost-Effectiveness of HPV Vaccination Compared with Pap Smear Screening on a National Scale: A Literature Review. Vaccine 26(49): 6258-6265.
This review compares the cost-effectiveness of various HPV vaccination programs and Pap smear screening programs by conducting a literature review.


Tello, M.A., M. Jenckes, J. Garver, J.R. Anderson, R.D. Moore, and G. Chander. August 2010. Barriers to Recommended Gynecologic Care in an Urban United States HIV Clinic. Journal of Women’s Health 19(8): 1511-1518.
Examines where women with HIV receive gynecologic services and barriers that contribute to underutilization by this population.


Tota, J.E., M. Chevarie-Davis, L.A. Richardson, M. deVries, and E.L. Franco. October 2011. Epidemiology and Burden of HPV Infection and Related Diseases: Implications for Preventive Strategies. Preventive Medicine 53(s1): s12-s21.
Examines the prevalence of HPV globally and discusses prevention strategies, including the HPV DNA test.


Vesco, K.K., E.P. Whitlock, M. Eder, et al. October 2011. Risk Factors and Other Epidemiologic Considerations for Cervical Cancer Screening: A Narrative Review for the US. Preventive Services Task Force. Annals of Internal Medicine Epub.
This article discusses the recently released guidelines for cervical cancer screening.


Whitlock, E.P., K.K. Vesco, M. Eder, et al. October 2011. Liquid-Based Cytology and Human Papillomavirus Testing to Screen for Cervical Cancer: A Systematic Review for the U.S. Preventive Services Task Force. Annals of Internal Medicine Epub.
This article reviews the evidence on HPV testing for the USPSTF, a test which has been recommended against in the newest guidelines.


Winer R.L., J.P. Hughes, Q. Feng, et al. June 2006. Condom use and the risk of genital human papillomavirus infection in young women. The New England Journal of Medicine 354(25):2645-5264.
This study evaluated the use of male condoms in reducing the risk of male-to-female HPV transmission.

Implementation and Efficacy of HPV Vaccines

Agosti, J.M. and S.J. Goldie. May 2007. Introducing HPV Vaccine in Developing Countries – Key Challenges and Issues. The New England Journal of Medicine 356(19):1908-1910.
This piece examines the availability of the HPV vaccine and the cost-effective factors of vaccinations internationally.


Bednarczyk, R.A. et al. October 2012. Sexual Activity-Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year-Olds. Pediatrics doi:10.1542 online edition. 
This study evaluated sexual activity-related clinical outcomes after adolescent vaccination. 


Castellasague, X, et al. December 2009. HPV vaccination against cervical cancer in women above 25 years of age: key considerations and current perspectives. Gynecologic Oncology 115(3):15-23.
The authors consider the potential benefits of HPV vaccination in sexually active women over the age of 25.


Cohen, S. Summer. 2007. A Long and Winding Road: Getting the HPV Vaccine to Women in the Developing World. Guttmacher Policy Review 10(3): 15-19
This report discusses incidence of cervical cancer in developing countries and addresses some of the challenges in broader use of HPV vaccines in these countries, such as cost, public education, and limited medical infrastructure.


D'Souza, G., and A. Dempsey. October 2011. The Role of HPV in Head and Neck Cancer and Review of the HPV Vaccine.  Preventive Medicine 53(S1): S5-S11.
This article reviews the epidemiology of oral human papillomavirus infection and the role of human papillomavirus in head and neck cancers. In addition, it reviews the known clinical indications for human papillomavirus vaccination, and highlights other potential clinical targets for the vaccine that have not yet been demonstrated in clinical trials but for which there is biologic plausibility.


Giuliano, A.R., J.M. Palefsky,S. Goldstone, et.al. February 2011. Efficacy of Quadrivalent HPV Vaccine against HPV Infection and Diseases in Males. New England Journal of Medicine 364: 401-411.
This study examines the safety and effectiveness of Gardasil preventing HPV infections in men.


Goldie, S.J., and J. Kim. August 2008. Health Economic Implications of HPV Vaccination in the U.S. The New England Journal of Medicine 359(8):821-832.
This article compares the cost-effectiveness of early vaccination and screening in various age groups of females.


Hirth, J.M., A. Tan, G.S. Wilkinson, and A.B. Berenson. April 2012. Completion of the Human Papillomavirus Vaccine Series Among Insured Females Between 2006 and 2009. Cancer; DOI: 10.1002/cncr.27598.



Jenson, H. 2009 Human papillomavirus vaccine: A paradigm shift for pediatricians. Pediatrics 21:112-121
This article discusses the importance of pediatricians’ knowledge and understanding of the HPV vaccine as well as awareness of any new developments licensure before use.


Kim, J J. February 2011. Focus on Research: Weighing the Benefits and Costs of HPV Vaccination of Young Men. The New England Journal of Medicine 364(5): 393-395.
This article discusses the recent debate surrounding men and the HPV vaccine. Since the vaccine has been approved for men, there has been an ongoing discussion about the necessity and implications of vaccinating men which is shown in this article.


Kim, J.J. and S.J. Goldie. October 2009 Cost effectiveness analysis of including boys in human papillomavirus vaccination programme in the United States. British Medical Journal 339:b3884
This study analyzes the cost effectiveness in screening preadolescent boys and girls and impact of a vaccination program.


Kreimer, A.R., A.C. Rodriguez, A. Hildesheim, et al. October 2011. Proof-of-Principle Evaluation of the Efficacy of Fewer Than Three Doses of a Bivalent HPV 16/18 Vaccine. Journal of the National Cancer Institute 103(19): 1444-1451.
Since one of the barriers to HPV vaccine series completion is the number of doses, this article examines whether two doses would provide adequate protection.


Levy, B. September 2009. Integrating HPV Vaccination Into Your Practice: Overcoming Common Barriers. The Journal of Family Practice 58(9):S11-3
This article address the practical aspects of the process if incorporating HPV vaccines into a medical practice.


Middleman, A.B. October 2011. Coordinating the Delivery of Vaccinations and Other Preventive Health Care Recommendations for Adolescents. Preventive Medicine 53(s1): S22-S28.
This paper reviews the history of recommendations for new vaccines as well as comprehensive health care visit recommendations for adolescents, how these recommendations may synergistically improve preventive care for adolescents, and how we may need to continue to think creatively to further access all youth for preventive health care using vaccination implementation as a model for reaching out beyond the providers' office walls.


Newall, A.T., P. Beutels, J.G. Wood, et al. April 2007. Cost-Effectiveness Analyses of Human Papillomavirus Vaccination. The Lancet 7(4):289-296.
This analysis summarizes and reviews the strengths and limitations of the methods and assumptions of studies that have modeled the cost-effectiveness of HPV vaccination.


Niccolai, L.M., N.R. Mehta, and J.L. Hadler. October 2011. Racial/Ethnic and Poverty Disparities in Human Papillomavirus Vaccination Completion. American Journal of Preventive Medicine 41(4): 428-433.
This study examines the effects of race/ethnicity, poverty, and age on completion of the HPV vaccine among those who initiated vaccination.

Outreach and Public Awareness

Barnack, J.L.,D.M. Reddy, and C. Swain.. January 2010. Predictors of Parents' Willingness to Vaccinate for Human Papillomavirus and Physicians' Intentions to Recommend the Vaccine. Women’s Health Issues 20(1): 28-34.
The authors surveyed parents about their willingness to vaccinate their children for HPV and physicians about their intentions to encourage parents to vaccinate their children.


Baxter, C. E. and P. C. Barata. May 2011.The Paradox of HPV Vaccines: How to Reach Sexually Inexperienced Women for Protection Against a Sexually Transmitted Infection. Women’s Health Issues 21(3): 239-245.
This article describes a survey in which the effectiveness of HPV Vaccine message is tested. The study tested to see if the message reached the correct audience, which is sexually inexperienced women, because of the need to vaccinate before the initiation of sexual activity.


Charo, R.A.. May 2007. Politics, Parents, and Prophylaxis – Mandating HPV Vaccination in the United States. The New England Journal of Medicine 356(10): 1905-1908.
This article explores areas of public health involving vaccination mandates, parental views, and opposition.


Colgrove, J., S. Abiola, and M.M. Mello. August 2011. HPV Vaccination Mandates- Lawmaking Amid Political and Scientific Controversy. New England Journal of Medicine 363: 785-791.
Examines the controversy surrounding HPV vaccine mandates for 11 and 12 year old girls through interviews of state policy makers and opinion leaders.


Cox, D., A. Cox,  L. Sturm, and G.D. Zimet. January 2010. Behavioral interventions to increase HPV acceptability among mothers of young girls. Health Psychology 29(1): 29-39.
This study presents research on the most effective way to present HPV risk and benefit information to mothers to increase intentions to vaccinate their daughters against HPV.


Gostin, L., and C. DeAngelis. May 2007. Mandatory HPV Vaccination: Public vs. Private Wealth. Journal of the American Medical Association 297:1921-1923.
This article discusses vaccination benefits and controversial issues that arise from mandating the HPV vaccine in the U.S.


Herzog, T.J., W.K. Huh, and M.H. Einstein. November 2010. How Does Public Policy Impact Cervical Cancer Screening and Vaccination Strategies? Gynecologic Oncology 119(2): 175-180.
This study examines the current approaches to cervical cancer screening and points to consider for improving HPV vaccination acceptance and uptake in the U.S.


Moreno, J., S. Berger, and J. Singer. January 2006. Don't Let Politics Interfere in the Fight Against Cervical Cancer. Center for American Progress
In this commentary, the authors argue for the use of an HPV vaccine as a mandatory vaccination for entry into public schools.


Rose, S.B., T. Lanumata, and B.A. Lawton. November 2011. Promoting Uptake of the HPV Vaccine: The Knowledge and Views of School Staff. Journal of School Health 81(11): 680-687.
Examines how the views of school officials affect immunization programs.


Rothman, S., Rothman, D. August 2009. Marketing HPV Vaccine: Implications for Adolescent Health and Medical Professionalism. The Journal of the American Medical Association 302(7):781-786
This piece focuses on the HPV vaccine marketing technique and discusses the impact of communication clinical practice.


Stupiansky, N.W., S.L. Rosenthal, S.E. Wiehe, and G.D. Zimet. September 2010. Human Papillomavirus Vaccine Acceptability Among a National Sample of Adult Women in the USA. Sexual Health 7(3): 304-309.
Examines acceptability of vaccination among women over age 26, as well as any health concerns related to vaccination of older women.


Trim, K., N. Nagii, L. Elit, and K. Roy. October 2011. Parental Knowledge, Attitudes, and Behaviors towards Human Papillomavirus Vaccination for Their Children: A Systematic Review from 2001 to 2011. Obstetrics and Gynecology International Epub.
A review of parental opinion surveys before and after the FDA approval of the HPV vaccines as well as immunization rates.


Wheeler, C.M. September 2011. Less is More: A Step in the Right Direction for Human Papillomavirus (HPV) Vaccine Implementation.  Journal of the National Cancer Institute 103(19): 1424-1425.
This article discusses methods and barriers for increased utilization of the vaccine.


Zimet, G.D., T.W. Weiss, S.L. Rosenthal, M.B. Good, and M.D. Vichnin. September 2010. Reasons for Non-Vaccination Against HPV and Future Vaccination Intentions Among 19-26 Year-Old Women. BMC Women’s Health 10:27.
This study attempts to better understand reasons for non-vaccination among insured 19-26 year old women and to evaluate future vaccination intentions, and provides recommendations for educational outreach.