Female genital tract lesions and neoplasms related to human papillomavirus infection. Predictable impact of the prophylactic vaccine

Abstract ?The discovery that cervical cancer is a rare consequence of a common infection is as momentous for public health as the demonstration of the association between cigarette smoking and lung cancer.? Most of the times the human papillomavirus (HPV) infection is cleared spontaneously, but since 1999 we know that it is the etiological factor for the cervical uterine cancer. Its association with cervical intraepithelial lesions and with other neoplasms and its precursors: vulvar, vaginal, penis, anal and nasopharyngeal carcinomas, has been demonstrated later. The relationship between HPV and other non-cancerous conditions as anogenital warts and recurrent respiratory papillomatosis has also been demonstrated. In the present article we review the burden, management and mortality of all these conditions and the etiological role of different types of HPV. The cancerous conditions usually are associated with High Risk HPV Genotypes in relation to their carcinogenetic potential (the most frequent are 16 y 18) whereas the non cancerous ones are associated with low risk HPV (6, 11). The tetravalent HPV vaccine with proved efficacy against HPV types 6, 11, 16 and 18, has been approved recently with an important expected impact on its morbidity and mortality. Key words: Cervical cancer, Vulvar cancer, Cervical intraepithelial neoplasia, Vulvar intraepithelial neoplasia, Anal cancer, Anal intraepithelial neoplasia, Genital warts, HPV vaccines.