Cervical Cancer Prevention Through HPV Vaccination in Low- and Middle-Income Countries in Asia

Document Type: Systematic Review and Meta-analysis

Authors

1 Pneumococcal Research, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia.

2 Department of Paediatrics, University of Melbourne, Australia.

3 Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.

4 Department of Obstetrics and Gynecology, University of Melbourne, The Royal Women’s Hospital and Murdoch Children’s Research Institute, Parkville, Victoria, Australia.

5 Regional WHO HPV Reference Laboratory, Department of Microbiology and Infectious Disease, The Royal Women’s Hospital, Parkville, VIC 3052, Australia.

6 National Cancer Council, Ulaanbaatar, Mongolia.

7 Menzies School of Health Research, Department of Child Health, Darwin, NT 08111, Australia.

8 London School of Hygiene and Tropical Medicine, University of London, WC1E 7HT, UK.

Abstract

 
Cervical cancer is ranked the first or second most common cancer in women of low- and middle-income countries (LMICs) in Asia. Cervical cancer is almost exclusively caused by human papillomavirus (HPV), and majority of the cases can be prevented with the use of HPV vaccines. The HPV vaccines have demonstrated high vaccine efficacies against HPV infection and cervical cancer precursors in clinical and post-marketing studies, and are in use in most high-income countries. However, their use in LMICs are limited mainly due to the high costs and logistics in delivering multiple doses of the vaccine. Other issues such as the safety of the vaccines, social and cultural factors, as well as poor knowledge and awareness of the virus have also contributed to the low uptake of the vaccine. This mini-review focuses on the need for HPV vaccine implementation in Asia given the substantial disease burden and underuse of HPV vaccines in LMICs in this region. In addition, the progress towards HPV vaccine introduction, and barriers preventing further rollout of these essential, life-saving vaccines are also discussed in this article.

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