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Prevention of cervical cancer through vaccination
Infection with one of ten genotypes of human papillomavirus (HPV), including, in particular, HPV16 and HPV18, constitutes 5% of the global cancer burden. The major cancer caused by these viruses, cervical cancer, is a late consequence of persisting infection with HPV, as are many anogenital (vulvar, anal, penile) and oropharyngeal cancers in younger men and women. Infection with the relevant papillomaviruses is extremely common, with over 50% of young men and women acquiring asymptomatic infection within 3 years of commencing sexual activity. However, 98% of infections resolve spontaneously in individuals with a competent immune system. The genetic and environmental determinants of persisting infection are otherwise largely unknown, though there is evidence that the immune response to HPV infection is to some extent genetically determined; therefore, programmes for prevention of cervical cancer must be provided globally as a public health measure if we are to prevent approximately 250000 deaths each year from cervical cancer.