Vaccination against human papillomavirus: What role will it play in proctology in 2024?
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Human papillomavirus (HPV) infection is considered to be the most common sexually transmitted infection worldwide. Although often asymptomatic due to viral clearance, persistent HPV infection may lead to the appearance of skin or mucosal lesions. Low-risk HPV infections can cause benign lesions such as condylomas. High-risk HPV infections can lead to the appearance of precancerous lesions and cancers, particularly in the cervix, anus, or head-and-neck area. In order to combat this widespread infection with a heavy epidemiological and economic burden, prophylactic vaccination (a primary prevention strategy) has been introduced in many countries. The marketed vaccines have a good safety profile with a follow-up of more than 15 years, and well-demonstrated effectiveness in preventing the appearance of benign, precancerous, and malignant HPV-induced lesions. The possible benefits of vaccination in secondary prevention have not been demonstrated. In France, vaccination is recommended for girls and boys aged 11 to 14, before the onset of sexual activity, for optimal effectiveness. Catch-up vaccinations are possible up to age 19, and up to age 26 for men who have sex with men. Vaccination coverage in France remains insufficient to achieve the eradication of HPV infection, a public health objective.
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