Primary and Secondary Prophylaxis for Diseases Caused by Human Papillomavirus Infections

人乳头瘤病毒感染所致疾病的一级和二级预防

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Abstract

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and a leading cause of several cancers, including cervical, anal, oropharyngeal, vulvar, vaginal, and penile cancers, as well as benign conditions such as genital warts. The global burden of HPV is particularly high in low- and middle-income countries due to disparities in vaccine accessibility, screening, and awareness. This review synthesizes recent advances in the primary and secondary prophylaxis of HPV-related diseases. Primary prophylaxis encompasses vaccination, education, and behavioral interventions. Although effective vaccines and gender-neutral vaccination policies exist, global uptake remains suboptimal, especially among males and in resource-limited settings. Different educational and school-based vaccination programs have demonstrated success in increasing coverage, while behavioral measures such as safe sexual practices, condom use, and male circumcision have been shown to reduce transmission risk. Secondary prophylaxis focuses on early detection and treatment of precancerous lesions, with HPV-DNA testing now the preferred method for cervical cancer screening, while standardized screening protocols for men are lacking. Treatment ranges from topical agents to excisional procedures and ablative therapies for cervical intraepithelial neoplasia and other precancerous lesions, depending on the type and severity. However, access to timely and effective treatment remains suboptimal in many regions. Addressing gaps in the primary and secondary prevention is essential for reducing the global impact of HPV and achieving international cancer prevention goals.

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