1.Infection of human papillomavirus and head and neck cancer.
Cheng SONG ; Shao Kai ZHANG ; You Lin QIAO
Chinese Journal of Oncology 2023;45(1):39-43
High-risk human papillomavirus (HPV)-related cancers consist of cervical cancer, anal cancer, penile cancer, vulvar cancer, vaginal cancer, and head and neck cancer (HNC). Of these, the disease burden of HNC is second only to cervical cancer. HNC mostly originates from malignant lesions of squamous epithelial cells and mainly includes oral cavity cancer, pharyngeal cancer (including nasopharyngeal cancer, oropharyngeal cancer, and hypopharyngeal cancer), and laryngeal cancer. Tobacco use, alcohol abuse, and HPV infection are three primary risk factors. Recently, there is an upward trend of HNC incidence globally, especially in high-income countries. In China, the disease burden and trends of HPV-related HNC are still not clear. A few small sample size and single-center studies suggest a high HPV prevalence and increasing trend in HNC. Methodological differences in HPV testing and regional variabilities still exist among these studies. Among the anatomic sites, oropharyngeal cancer has been shown to be caused by HPV infection, but the association of HPV with other sites is still under debate. In addition, there is a paucity of relevant studies. Here, this review narrates the association between HPV infection and HNC, compares the differences between global and Chinese studies, and then explores the importance of HPV infection in various anatomical sites. The main objective is to highlight the research on HPV-related HNC and promote relevant prevention and treatment programs.
Female
;
Humans
;
Human Papillomavirus Viruses
;
Papillomavirus Infections/prevention & control*
;
Uterine Cervical Neoplasms/complications*
;
Nasopharyngeal Neoplasms/complications*
;
Head and Neck Neoplasms/epidemiology*
;
Oropharyngeal Neoplasms/epidemiology*
;
Papillomaviridae
2.Expert consensus on the immunization strategy and practice of human papillomavirus vaccine for female adolescents in the Yangtze River Delta region.
Chinese Journal of Preventive Medicine 2023;57(2):135-153
Persistent infection of high-risk human papillomavirus (HPV) is the leading cause of cervical cancer. In order to achieve the goal of cervical cancer elimination, the World Health Organization (WHO) proposed the "90-70-90" goal, one of which is "90% of girls fully vaccinated with HPV vaccine by age 15 years". Based on the epidemiological characteristics of HPV infection and the characteristics of HPV vaccine, it is important to give priority to female adolescents to be vaccinated with HPV vaccine. CAV Affiliated Association for Standardized Management and Practice of Immunization Program organized an expert group to develop an expert consensus on the immunization strategy and practice of human papillomavirus vaccine for female adolescents in the Yangtze River Delta region. This consensus introduces HPV infection and related disease burden, safety, efficacy and effectiveness of HPV vaccination for female adolescents, factors affecting the health benefits of HPV vaccination for female adolescents, current HPV vaccination strategies for female adolescents, the expert advice, common problems and precautions in the Yangtze River Delta region. This consensus is developed to guide HPV vaccination for female adolescents in the Yangtze River Delta region and provide reference for other regions.
Female
;
Adolescent
;
Humans
;
Papillomavirus Vaccines
;
Papillomavirus Infections/prevention & control*
;
Human Papillomavirus Viruses
;
Uterine Cervical Neoplasms/prevention & control*
;
Consensus
;
Vaccination
;
Immunization Programs
3.Improved population coverage of the human papillomavirus vaccine after implementation of a school-based vaccination programme: the Singapore experience.
Karuppiah VIJAYALAKSHMI ; Anne Hui Yi GOEI
Singapore medical journal 2023;64(5):294-301
INTRODUCTION:
Cervical cancer has a high disease burden in Singapore, and it is strongly associated with human papillomavirus (HPV) infections. Despite constant efforts to encourage vaccination, local HPV vaccine uptake remains low. Universal mass vaccination is a proven cost-effective method to reduce the cervical cancer disease burden. This paper reviews the newly implemented school-based HPV vaccination programme in Singapore and the factors that led to its success.
METHODS:
Fully subsidised HPV vaccinations were offered to all Secondary 1 female students on an opt-in basis, starting as a rollout dose in 2019. One-time catchup vaccination was also offered to female students in Secondary 2-5. Eligible recipients were identified using enrolment data provided by Ministry of Education schools. A total of 19,144 students across 139 schools were offered the rollout dose, and 20,854 students across 140 schools were offered the catchup doses.
RESULTS:
High vaccine uptake rates of 80.6%-87.3% were noted with the introduction of the school-based programme, translating to high vaccine coverage of 90.3%-93.4%. Only a small proportion of students (1.5%-1.9% per cohort) opted out. The rate of reported side effects, which were commonly known effects, was low at one in 1000. Among the students who reported side effects, those who received the second vaccine dose did so uneventfully.
CONCLUSION
High HPV vaccine coverage was achieved after implementation of the school-based immunisation programme. Timely assessment of knowledge lapses and targeted intervention, strong partnerships with stakeholders, constant on-site adaptation and positive social influence contributed to its success. This model can be applied to future school health programmes.
Humans
;
Female
;
Papillomavirus Vaccines/therapeutic use*
;
Human Papillomavirus Viruses
;
Papillomavirus Infections/prevention & control*
;
Singapore
;
Uterine Cervical Neoplasms/epidemiology*
;
Vaccination
;
Immunization Programs
4.Current status of clinical trials of HPV therapeutic vaccines.
Chinese Journal of Preventive Medicine 2023;57(10):1647-1654
Cervical cancer mainly caused by human papillomavirus (HPV) infection has become a public health issue, which seriously threatens women 's health. To prevent HPV infection, the currently used prophylactic vaccines mainly induce a humoral immune response in the host, thereby generating neutralizing antibodies. In contrast, the design goal of therapeutic HPV vaccines is to induce a cell-mediated immune response in the host, primarily driven by Th1 cells, aiming to clear existing viral infections and slow down or inhibit tumor progression. Currently, several therapeutic HPV vaccines based on different mechanisms and techniques have entered clinical trials. This review will summarize the progress of these clinical trials, providing reference for the research and development of therapeutic HPV vaccines.
Female
;
Humans
;
Papillomavirus Vaccines/therapeutic use*
;
Papillomavirus Infections/prevention & control*
;
Uterine Cervical Neoplasms
;
Immunity, Cellular
;
Papillomaviridae
5.Current status of clinical trials of HPV therapeutic vaccines.
Chinese Journal of Preventive Medicine 2023;57(10):1647-1654
Cervical cancer mainly caused by human papillomavirus (HPV) infection has become a public health issue, which seriously threatens women 's health. To prevent HPV infection, the currently used prophylactic vaccines mainly induce a humoral immune response in the host, thereby generating neutralizing antibodies. In contrast, the design goal of therapeutic HPV vaccines is to induce a cell-mediated immune response in the host, primarily driven by Th1 cells, aiming to clear existing viral infections and slow down or inhibit tumor progression. Currently, several therapeutic HPV vaccines based on different mechanisms and techniques have entered clinical trials. This review will summarize the progress of these clinical trials, providing reference for the research and development of therapeutic HPV vaccines.
Female
;
Humans
;
Papillomavirus Vaccines/therapeutic use*
;
Papillomavirus Infections/prevention & control*
;
Uterine Cervical Neoplasms
;
Immunity, Cellular
;
Papillomaviridae
7.Causes and countermeasures of the rapidly rising burden on cervical cancer in Chinese women.
Hao CHEN ; Chang Fa XIA ; Ting Ting YOU ; You Lin QIAO ; Fang Hui ZHAO
Chinese Journal of Epidemiology 2022;43(5):761-765
The world is entering a new era of accelerated elimination of cervical cancer, while the age-standardized incidence, and mortality of cervical cancer in China are rising rapidly. This article summarizes and describes the current situation and trends of the burden of cervical cancer in China, reviews and analyzes the comprehensive prevention practice of cervical cancer, focusing on critical reasons for the increasing burden of cervical cancer, from the perspectives of sociology, behavior, and epidemiology in the population. Countermeasures are proposed to provide guidance and theoretical reference for the precise prevention of cervical cancer to eliminate cervical cancer.
Asians
;
Causality
;
China/epidemiology*
;
Female
;
Humans
;
Incidence
;
Uterine Cervical Neoplasms/prevention & control*
8.Clinical research progress and implications of therapeutic vaccines for cervical cancer and precancerous lesions: a qualitative systematic review.
Shan CAI ; Ke MIAO ; Xiao Yu TAN ; Si CHENG ; Dan Tong LI ; Xue Yang ZENG ; Yu YANG ; Ruo Gu MENG ; Zhi Ke LIU ; Yan LI ; Ke Li LI ; Feng SUN ; Si Yan ZHAN
Chinese Journal of Oncology 2022;44(7):743-760
Objective: To systematically summarize and analyze the clinical research progress of therapeutic vaccines for cervical cancer or precancerous lesions. Methods: English databases (PubMed, Embase, Web of Science, Cochrane library, Proquest, and ClinicalTrails.gov) and Chinese databases (SinoMed, CNKI, WanFang, and VIP Database) were systematically searched to collect literature on therapeutic vaccines for cervical cancer or precancerous lesions from inception to February 18, 2021. After screening, we evaluated the risk of bias of included studies, and combed the basic information of the literature, research designs, information of vaccines, study patients, outcome indicators and so on, qualitatively summarized the clinical research progress. Results: A total of 71 studies were included in this systematic review, including 14 random controlled trials, 15 quasi-random controlled trials, 4 cohort studies, 1 case-control study, 34 case series studies and 3 case reports. The study patients included women aged 15~79 with cervical cancer or precancerous lesions in 18 countries from 1989 to 2021. On the one hand, there were 40 studies on therapeutic vaccines for cervical precancerous lesions (22 867 participants), involving 21 kinds of vaccines in 6 categories. Results showed 3 marketed vaccines (Cervarix, Gardasil, Gardasil 9) as adjuvant immunotherapies were significant effective in preventing the recurrence of precancerous lesions compared with the conization only. In addition, MVA E2 vaccine had been in phase Ⅲ clinical trials as a specific therapeutic vaccine, with relative literature showing it could eliminate most high-grade precancerous lesions. Therapeutic vaccines for precancerous lesions all showed good safety. On the other hand, there were 31 studies on therapeutic vaccines for cervical cancer (781 participants), involving 19 kinds of vaccines in 7categories, with none had been marketed. 25 studies were with no control group, showing the vaccines could effectively eliminate solid tumors, prevent recurrence, and prolong the median survival time. However, the vaccines effectiveness couldn't be statistically calculated due to the lack of a control group. As for the safety of therapeutic vaccines for cervical cancer, 9 studies showed that patients experienced serious adverse events after treatments, where 7 studies reported that serious adverse events occurred in patients couldn't be ruled out as the results of therapeutic vaccines. Conclusions: The literature review shows that the literature evidence for the therapeutic vaccines for cervical precancerous lesions is relatively mature compared with the therapeutic vaccines for cervical cancer. The four kinds of vaccines on the market are all therapeutic vaccines for precancerous lesions, but they are generally used as vaginal infection treatments or adjuvant immunotherapies for cervical precancerous lesions, not used for the specific treatments of cervical precancerous lesions. Other specific therapeutic vaccines are in the early stage of clinical trials, mainly phase Ⅰ/Ⅱ clinical trials with small sample size. The effectiveness and safety data are limited, and further research is still needed.
Cancer Vaccines/therapeutic use*
;
Cervical Intraepithelial Neoplasia/prevention & control*
;
Female
;
Humans
;
Papillomavirus Infections/prevention & control*
;
Papillomavirus Vaccines/therapeutic use*
;
Precancerous Conditions/therapy*
;
Uterine Cervical Neoplasms/prevention & control*
9.Expert recommendations on human papillomavirus vaccine immunization strategies in China.
Xi Xi ZHANG ; Wen WANG ; Yi Fan SONG ; Zhao Nan ZHANG ; Wen Zhou YU
Chinese Journal of Preventive Medicine 2022;56(9):1165-1174
HPV vaccination is the most effective way for preventing the cervical cancer. To respond the WHO calling for cervical cancer elimination, some Chinese provincial governments are launching the Free HPV Vaccination Programs for teenagers. Basing on the current stage of domestic utilization and the global immunization strategies of HPV vaccination, this paper provides a comprehensive review of the key aspects in the process of HPV vaccination, including subjects and priority vaccination population, vaccination dose and time interval, the principal of vaccination replacement, and the vaccination suggestion on special populations, etc. The article above contents and gives the advice on the immunization strategy of HPV vaccination in China.
AIDS Vaccines
;
Adolescent
;
BCG Vaccine
;
China
;
Diphtheria-Tetanus-Pertussis Vaccine
;
Female
;
Humans
;
Immunization Programs
;
Influenza Vaccines
;
Measles-Mumps-Rubella Vaccine
;
Papillomavirus Infections/prevention & control*
;
Papillomavirus Vaccines
;
Respiratory Syncytial Virus Vaccines
;
SAIDS Vaccines
;
Uterine Cervical Neoplasms
;
Vaccination
10.Application progress of home self-sampling for human papillomavirus and human immunodeficiency virus testing.
Shui Xiang QU ; Jian Fen QIN ; Yi Hua NI ; Xiao Yan CHEN ; Aiqing YE
Chinese Journal of Preventive Medicine 2022;56(11):1668-1674
Self-sampling is a method by which the subject collects the own specimens for disease detection. It has the advantages of strong privacy, convenient and simple operation, free time and place, etc. It can improve the compliance of people in remote areas, affected by traditional concepts, limited by working hours and underdeveloped transportation and medical treatment to participate in disease detection and screening. With the development of "Internet+health care" and "Internet+nursing service", home-based self-sampling testing will become a developing situation for disease detection and screening. Human immunodeficiency virus and Human papillomavirus infection bring a heavy burden to individuals and society. In the absence of effective and widespread primary prevention, secondary prevention, namely "early detection, early diagnosis and early treatment" is an effective measure to control the adverse consequences. At present, there are many researches on HPV and HIV self-sampling test, whose test results are highly reliable and highly accepted in the population, and is of great significance for improving the coverage rate of cervical cancer screening and the diagnosis rate of HIV carriers.
Female
;
Humans
;
Papillomaviridae
;
Early Detection of Cancer/methods*
;
Uterine Cervical Neoplasms/prevention & control*
;
Alphapapillomavirus
;
Self Care/methods*
;
Papillomavirus Infections/prevention & control*
;
Specimen Handling/methods*
;
Mass Screening/methods*
;
HIV Infections/diagnosis*
;
HIV
;
Vaginal Smears/methods*

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