Human Papillomavirus (HPV) Infection
Human papillomavirus (HPV) infection is recognized as one of the most common – if not the most common – sexually transmitted infections. The association between HPV and cervical cancer has also been recognized, while more recently it has been associated with some other types of cancer, primarily those in the genital region.
Our understanding of HPV has advanced considerably in the past decade. In fact, we now speak of human papillomavirus infections since there are roughly 100 viruses of varying pathogenecity. New technologies used for detection are being developed with increasing speed, new treatments are available and research on therapeutic or preventive vaccines continues to show promise.
Nonetheless, there is no doubt that HPV infections are a major public health problem.
Recognizing the magnitude of a public health problem is the first step in prevention. However, it is important to fully understand the various components of this problem in order to identify the strategies and means of intervention that are most likely to make a real impact on population health. Thus, preventing cervical cancer and other cancers associated with HPV infection has unquestionably become a major public health objective. While considerable advances have been observed over the past several decades in reducing the incidence of cervical cancer thanks to the general use of the Pap test to detect cervical cancer, it would not be wise to believe that the incidence will continue to decline without improved preventive measures.
Preventing other HPV-associated cancers has also become an increasingly major concern. Nor can we overlook the impact of human immunodeficiency virus (HIV) on the evolution of the HPV infection. Besides the morbidity associated with cancers caused by HPV, we are also seeing a greater recognition of the morbidity associated with the infection itself, particularly the psychological impact on those infected. Finally, the understanding of the limited resources of the health care network forces us to consider, more than ever, the cost-effectiveness of any preventive or curative measures we may develop.
We have therefore conducted a survey of the scientific literature to present an overall portrait of the situation, taking into consideration the various aspects of the problem. However, faced with the extremely rapid expansion of HPV-related knowledge, not to mention results that are sometimes inconsistent with published studies and the growing complexity of technological aspects, we sought to validate our literature survey by enlisting a panel of Quebecer experts.
We hope that the results of this project will be used to plan measures to prevent human papillomavirus infections and their complications and contribute to the making of sound decisions based on scientific evidence. Nonetheless, considering the number of unanswered questions that were raised over the course of our research, we believe that this step is merely the starting point for an ongoing process of updating our understanding of the situation and establishing close ties between researchers and decision makers.