Abstract
HPV infection is probably the most frequent sexually transmitted disease. At least 13 HPV genotypes are classifi ed as carcinogenic or probably carcinogenic in respect to cervical cancer.
Almost 100% of cervical cancers are linked to HPV infection. HPV 16 and HPV 18 are the most frequently involved genotypes and account together for approximately 70% of cervical cancer in the world.
Persistent high-risk HPV infection is responsible for a signifi cant proportion of vulvar, vaginal, anal and penile carcinomas. The virus has also been implicated in oncogenesis of head and neck cancers, including oropharyngeal cancers.
HPV infection can play an important role in cancerogenesis of lung, esophagus, breast, and colon and rectum. On the contrary, published results indicate that HPV infection is not associated with prostate oncogenesis.
Strong predominance of HPV 16 has been reported for all HPV-associated cancer sites. Generally, it is estimated that approximately 5.2% of all cancers are associated with oncogenic HPV infection.
Currently, there are two vaccines on the market; quadrivalent Silgard(R) (Gardasil(R)) and bivalent CervarixTM. Large trials for both vaccines have shown effi cacy against HPV-related infection and disease.
Effi cacy has been very high in HPV naive subjects to vaccine related types. While HPV vaccination is currently approved for the prevention of cervical cancer, it also has the potential in the prevention of all HPV-associated malignancies.
The Czech republic belongs to countries that cover HPV vaccination of girls at the age of 13-14 years by general health insurance. Overall impact of this vaccination remains to be evaluated.
The new issues of the role of HPV in oncogenesis, as well as the potential eff ect of HPV vaccination against HPV-related nongenital cancers are discussed.