Gestione nelle Regioni italiane delle coorti incluse nella vaccinazione; differenze tra l’Italia e i principali Paesi europei e non, in Rivalutazione della vaccinazione anti-HPV a 5 anni dalla sua introduzione. HTA 2.0

[Autom. eng. transl.] Human Papilloma Virus (HPV) infection is very common in the female population: it is estimated, in fact, that at least 75% of sexually active women become infected during their lives with an HPV virus of any kind and that over 50 % become infected with a high-risk cancer type; among these, serotypes 16 and 18 are responsible for over 70% of cervical cancer cases. The latter represents the second most common type of female cancer, with around 500,000 new cases a year and 250,000 deaths worldwide, and is the first cancer recognized by the World Health Organization (WHO) as totally attributable to an infection , that of HPV. In Italy, about 3,500 new cases of cervical cancer occur and 1,000 deaths occur every year. In August 2006, the WHO published a guide for the introduction of anti-HPV vaccines, according to which preadolescents between 9 and 13 years of age represent the primary target, as vaccination at this age and before the beginning of sexual intercourse is particularly advantageous because it induces very high immunity levels before a possible contact with HPV. The vaccination against HPV is different from the others included in the vaccination calendar as it prevents a sexually transmitted infection that can develop into cancer and also the target is particular because it is currently recommended for pre-adolescent girls. The availability of these vaccines, therefore, constitutes a fundamental prevention opportunity that must take into consideration a series of significant aspects such as: the duration of the effectiveness and the possible need for reminders over time, the identification of the target, in terms of age and gender of the subjects to be offered vaccination and feasibility of vaccination strategies, taking into account the social implications of a vaccine against a sexually transmitted disease addressed to adolescents. The impact of HPV vaccination on screening policies should also be emphasized: vaccination, in fact, does not prevent all high-risk HPV infections and it is therefore necessary for vaccination campaigns to go alongside organized screening activities, since the two preventive interventions, primary and secondary, are complementary.