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Assessment of HPV Types in Cancers

Article Title: US Assessment of HPV Types in Cancers: Implications for Current and 9-Valent HPV Vaccines

A CDC study published in the Journal of the National Cancer Institute tested tissue samples of the types of cancers that are known to be associated with human papillomavirus (HPV) to see what HPV types were found in the cancers. Researchers tested the types of HPV in cancers of the vulva, vagina, penis, anus, and oropharynx (cancers of the back of the throat, including the base of the tongue and tonsils) from seven cancer registries. This information can be used to estimate the percentage and numbers of these six HPV-associated cancers that HPV vaccines could prevent. The study found that if everyone was vaccinated as recommended using the bivalent HPV vaccine, close to 25,000 HPV-associated cancers could be prevented in the United States each year. If everyone was vaccinated as recommended using the new 9-valent HPV vaccine, about 29,000 cancers can be prevented each year.

Basics about HPV

What is HPV?

Human papillomavirus (HPV) causes most cervical cancers, as well as some cancers of the vulva, vagina, penis, anus, and oropharynx (cancers of the back of the throat, including the base of the tongue and tonsils). HPV is a group of more than 150 related viruses, each identified by a number known as a type. Some HPV types can cause genital warts, and other types can cause cancer, although most HPV infections do not lead to cancer.

What vaccines are available for HPV?

Three vaccines have been developed to prevent HPV:

  • The bivalent HPV vaccine targets two cancer-causing HPV types: HPV 16 and 18.
  • The quadrivalent vaccine targets HPV 16 and 18 plus two more HPV types that cause genital warts: HPV 6 and 11.
  • The 9-valent vaccine targets HPV 6, 11, 16, and 18 plus five more cancer-causing types: HPV 31, 33, 45, 52, and 58.

Key Findings

  • More than 80% of all cervical cancers can be prevented with the 9-valent HPV vaccine, offering 15% more protection than previous vaccines.
  • The 9-valent vaccine can potentially protect against an additional 18% of vaginal, 14% of vulvar, 9% of penile, 8% of anal, and 6% of oropharyngeal cancers.
  • Women with cervical cancer that was HVP 16 or 18 were often diagnosed at a younger age than women who had other HPV types or women without HPV.
  • The potential protection of HPV vaccines does not differ by race or ethnicity for invasive cervical, vulvar, penile, and anal cancers.
  • African Americans with invasive oropharyngeal cancer were less likely to have HPV compared with members of other racial and ethnic groups.
  • HPV was found in 91% of cervical and anal cancers, 75% of vaginal cancers, 70% of oropharyngeal cancers, 69% of vulvar cancers, and 63% of penile cancers.

About This Study

This study shows the feasibility of using cancer registries to assess the potential impact of HPV vaccines on cancers in the United States. The researchers used demographic and clinical data from cancer registries for Florida, Hawaii, Iowa, Kentucky, Louisiana, Los Angeles County, and Michigan. The researchers also compared the sample of cancer cases that they tested to other cancer cases in each state and found no differences in the distribution of cases by sex or age. This will be important for measuring the impact of HPV vaccine in these states in the future.

Cancer registries do not collect information about HPV type regularly. The findings from this study provide an important starting point for more accurate estimates of the HPV-associated cancers that can be prevented with HPV vaccines in the United States.

CDC is working to understand more about the health impact of HPV-associated cancers and HPV vaccines. Learn more about what CDC is doing about HPV and cancer.

What CDC is Doing

CDC is working to understand more about the health impact of HPV-associated cancers and HPV vaccines with the following activities:

  1. Surveillance and disease tracking:
    1. State Programs: CDC established and supports the National Program of Cancer Registries for 45 states and territories to collect surveillance data for all cancers. Funded programs use the data to develop burden assessments and guide program planning.
    2. Various projects are ongoing to monitor early outcomes of HPV infection and impact of HPV vaccination on genital warts and pre-cancers.
  2. Collaboration:
    1. CDC provides access to breast and cervical cancer screening for underserved women in the United States through the National Breast and Cervical Cancer Early Detection Program.
    2. CDC supports the Vaccines for Children (VCF) program by providing vaccines to state health departments and local public health agencies for individuals who may not be vaccinated because of inability to pay.
    3. CDC developed the national gynecologic cancer awareness campaign, Inside Knowledge: Get the Facts about Gynecologic Cancers, to raise awareness for gynecologic cancers.
    4. CDC developed an HPV education campaign, HPV: Common Infection, Common Reality to provide information to the general public, doctors, and women diagnosed with HPV.
    5. CDC developed the Preteen Vaccine Campaign to inform parents, family physicians, and pediatricians about vaccination recommendations (including the HPV vaccine) for 11- and 12-year-old boys and girls.

More Information

Please visit the following links for more information about the following:

HPV and Cancer 

HPV Vaccines 

Put “HPV Cancer Prevention” on Your Back-to-School Checklist 

National Breast and Cervical Cancer Early Detection Program 


Saraiya M, Unger E, Thompson T, et al. US assessment of HPV types in cancers: Implications for current and 9-valent HPV Vaccines. J Natl Cancer Inst. 2015;107(6):online first. doi: 10.1093/jnci/djv086.