1887
Review Open Access
Like 0

Abstract

Background: A National human papilloma virus (HPV) Vaccination Programme for the prevention of HPV infection and associated disease using the quadrivalent HPV vaccine (4vHPV) has been funded and implemented in Australia since 2007, initially for girls only and extended to boys in 2013, with uptake rates among the highest observed worldwide. Aim: We report on the impact of this national programme on HPV prevalence and associated disease burden and estimate the potential impact of adopting a nonavalent HPV (9vHPV) vaccine. Methods: We performed a non-systematic literature review of studies measuring the burden of HPV-associated disease and infection in Australia before and after introduction of HPV vaccination. We also included key national reports with estimates of HPV-related disease burden. Results: Substantial declines in high-grade cervical disease and genital warts among vaccine-eligible women have been observed. Reductions in genital warts incidence and HPV prevalence among heterosexual men of similar age were observed before introduction of the male vaccination programme, indicating a substantial herd effect. 9vHPV vaccine is expected to prevent up to 90% of cervical and 96% of anal cancers. Of an estimated 1,544 HPV-associated cancers in 2012, 1,242 would have been preventable by the 4vHPV vaccine and an additional 187 anogenital cancers by the 9vHPV vaccine. Conclusions: Vaccination using 4vHPV vaccine has had a large demonstrable impact on HPV-related disease in Australia. A switch to 9vHPV could further reduce the HPV-associated cancer burden. With continued high coverage among both males and females, elimination of vaccine-type HPV disease seems achievable in Australia.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2018.23.41.1700737
2018-10-11
2024-12-25
/content/10.2807/1560-7917.ES.2018.23.41.1700737
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/23/41/eurosurv-23-41-5.html?itemId=/content/10.2807/1560-7917.ES.2018.23.41.1700737&mimeType=html&fmt=ahah

References

  1. Australian Institute of Health and Welfare (AIHW). Cervical screening in Australia 2018. Cat. no. CAN 111. Canberra: AIHW; 2018. Available from: https://www.aihw.gov.au/reports/cancer-screening/cervical-screening-in-australia-2018/contents/table-of-contents
  2. Condon JR, Zhang X, Dempsey K, Garling L, Guthridge S. Trends in cancer incidence and survival for Indigenous and non-Indigenous people in the Northern Territory. Med J Aust. 2016;205(10):454-8.  https://doi.org/10.5694/mja16.00588  PMID: 27852183 
  3. Jin F, Stein AN, Conway EL, Regan DG, Law M, Brotherton JM, et al. Trends in anal cancer in Australia, 1982-2005. Vaccine. 2011;29(12):2322-7.  https://doi.org/10.1016/j.vaccine.2011.01.015  PMID: 21255682 
  4. Australian Institute of Health and Welfare (AIHW). Australian cancer incidence and mortality (ACIM) books: Anal cancer. Canberra: AIHW; 2016.
  5. Machalek DA, Poynten M, Jin F, Fairley CK, Farnsworth A, Garland SM, et al. Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis. Lancet Oncol. 2012;13(5):487-500.  https://doi.org/10.1016/S1470-2045(12)70080-3  PMID: 22445259 
  6. Vajdic CM, van Leeuwen MT, Jin F, Prestage G, Medley G, Hillman RJ, et al. Anal human papillomavirus genotype diversity and co-infection in a community-based sample of homosexual men. Sex Transm Infect. 2009;85(5):330-5.  https://doi.org/10.1136/sti.2008.034744  PMID: 19342375 
  7. Poynten IM, Tabrizi SN, Jin F, Templeton DJ, Machalek DA, Cornall A, et al. SPANC Study Team. Vaccine-preventable anal human papillomavirus in Australian gay and bisexual men. Papillomavirus Res. 2017;3:80-4.  https://doi.org/10.1016/j.pvr.2017.02.003  PMID: 28720461 
  8. Grulich AE, Jin F, Conway EL, Stein AN, Hocking J. Cancers attributable to human papillomavirus infection. Sex Health. 2010;7(3):244-52.  https://doi.org/10.1071/SH10020  PMID: 20719211 
  9. Wakeham K, Kavanagh K. The burden of HPV-associated anogenital cancers. Curr Oncol Rep. 2014;16(9):402.  https://doi.org/10.1007/s11912-014-0402-4  PMID: 25118645 
  10. Condon JR, Rumbold AR, Thorn JC, O’Brien MM, Davy MJ, Zardawi I. A cluster of vulvar cancer and vulvar intraepithelial neoplasia in young Australian indigenous women. Cancer Causes Control. 2009;20(1):67-74.  https://doi.org/10.1007/s10552-008-9218-6  PMID: 18766449 
  11. Ariyawardana A, Johnson NW. Trends of lip, oral cavity and oropharyngeal cancers in Australia 1982-2008: overall good news but with rising rates in the oropharynx. BMC Cancer. 2013;13(1):333.  https://doi.org/10.1186/1471-2407-13-333  PMID: 23829309 
  12. Hocking JS, Stein A, Conway EL, Regan D, Grulich A, Law M, et al. Head and neck cancer in Australia between 1982 and 2005 show increasing incidence of potentially HPV-associated oropharyngeal cancers. Br J Cancer. 2011;104(5):886-91.  https://doi.org/10.1038/sj.bjc.6606091  PMID: 21285981 
  13. Hong A, Lee CS, Jones D, Veillard AS, Zhang M, Zhang X, et al. Rising prevalence of human papillomavirus-related oropharyngeal cancer in Australia over the last 2 decades. Head Neck. 2016;38(5):743-50.  https://doi.org/10.1002/hed.23942  PMID: 25521312 
  14. Elwood JM, Youlden DR, Chelimo C, Ioannides SJ, Baade PD. Comparison of oropharyngeal and oral cavity squamous cell cancer incidence and trends in New Zealand and Queensland, Australia. Cancer Epidemiol. 2014;38(1):16-21.  https://doi.org/10.1016/j.canep.2013.12.004  PMID: 24445141 
  15. Chaturvedi AK, Anderson WF, Lortet-Tieulent J, Curado MP, Ferlay J, Franceschi S, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol. 2013;31(36):4550-9.  https://doi.org/10.1200/JCO.2013.50.3870  PMID: 24248688 
  16. Chow EP, Danielewski JA, Fehler G, Tabrizi SN, Law MG, Bradshaw CS, et al. Human papillomavirus in young women with Chlamydia trachomatis infection 7 years after the Australian human papillomavirus vaccination programme: a cross-sectional study. Lancet Infect Dis. 2015;15(11):1314-23.  https://doi.org/10.1016/S1473-3099(15)00055-9  PMID: 26201300 
  17. Tabrizi SN, Brotherton JML, Kaldor JM, Skinner SR, Cummins E, Liu B, et al. Fall in human papillomavirus prevalence following a national vaccination program. J Infect Dis. 2012;206(11):1645-51.  https://doi.org/10.1093/infdis/jis590  PMID: 23087430 
  18. Tabrizi SN, Brotherton JM, Kaldor JM, Skinner SR, Liu B, Bateson D, et al. Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross-sectional study. Lancet Infect Dis. 2014;14(10):958-66.  https://doi.org/10.1016/S1473-3099(14)70841-2  PMID: 25107680 
  19. Osborne SL, Tabrizi SN, Brotherton JM, Cornall AM, Wark JD, Wrede CD, et al. VACCINE Study group. Assessing genital human papillomavirus genoprevalence in young Australian women following the introduction of a national vaccination program. Vaccine. 2015;33(1):201-8.  https://doi.org/10.1016/j.vaccine.2014.10.045  PMID: 25444787 
  20. Tabrizi SN, Brotherton JM, Stevens MP, Condon JR, McIntyre P, Smith D, et al. WHINURS group. HPV genotype prevalence in Australian women undergoing routine cervical screening by cytology status prior to implementation of an HPV vaccination program. J Clin Virol. 2014;60(3):250-6.  https://doi.org/10.1016/j.jcv.2014.04.013  PMID: 24854516 
  21. Machalek DA, Garland SM, Brotherton JML, Bateson D, McNamee K, Stewart M, et al. Very low prevalence of vaccine human papillomavirus types among 18- to 35-year old Australian women 9 years following implementation of vaccination. J Infect Dis. 2018;217(10):1590-600.  https://doi.org/10.1093/infdis/jiy075  PMID: 29425358 
  22. Drolet M, Bénard É, Boily MC, Ali H, Baandrup L, Bauer H, et al. Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2015;15(5):565-80.  https://doi.org/10.1016/S1473-3099(14)71073-4  PMID: 25744474 
  23. Chow EPF, Machalek DA, Tabrizi SN, Danielewski JA, Fehler G, Bradshaw CS, et al. Quadrivalent vaccine-targeted human papillomavirus genotypes in heterosexual men after the Australian female human papillomavirus vaccination programme: a retrospective observational study. Lancet Infect Dis. 2017;17(1):68-77.  https://doi.org/10.1016/S1473-3099(16)30116-5  PMID: 27282422 
  24. Pillsbury AJ, Quinn HE, Evans TD, McIntyre PB, Brotherton JML. Population-level herd protection of males from a female human papillomavirus vaccination program: evidence from Australian serosurveillance. Clin Infect Dis. 2017;65(5):827-32.  https://doi.org/10.1093/cid/cix436  PMID: 29017279 
  25. Australian Institute of Health and Welfare (AIHW). Cervical screening in Australia 2013-2014. Cancer series no. 97. Cat. no. CAN 95. Canberra: AIHW; 2016.
  26. Gertig DM, Brotherton JM, Budd AC, Drennan K, Chappell G, Saville AM. Impact of a population-based HPV vaccination program on cervical abnormalities: a data linkage study. BMC Med. 2013;11(1):227.  https://doi.org/10.1186/1741-7015-11-227  PMID: 24148310 
  27. Brotherton JML, Malloy M, Budd AC, Saville M, Drennan KT, Gertig DM. Effectiveness of less than three doses of quadrivalent human papillomavirus vaccine against cervical intraepithelial neoplasia when administered using a standard dose spacing schedule: Observational cohort of young women in Australia. Papillomavirus Research.2015;1:59-73.  https://doi.org/10.1016/j.pvr.2015.05.005 
  28. Crowe E, Pandeya N, Brotherton JM, Dobson AJ, Kisely S, Lambert SB, et al. Effectiveness of quadrivalent human papillomavirus vaccine for the prevention of cervical abnormalities: case-control study nested within a population based screening programme in Australia. BMJ. 2014;348(mar04 2):g1458.  https://doi.org/10.1136/bmj.g1458  PMID: 24594809 
  29. Smith MA, Liu B, McIntyre P, Menzies R, Dey A, Canfell K. Fall in genital warts diagnoses in the general and indigenous Australian population following implementation of a national human papillomavirus vaccination program: analysis of routinely collected national hospital data. J Infect Dis. 2015;211(1):91-9.  https://doi.org/10.1093/infdis/jiu370  PMID: 25117753 
  30. Drolet M, Laprise JF, Brotherton JML, Donovan B, Fairley CK, Ali H, et al. The impact of human papillomavirus catch-up vaccination in Australia: implications for introduction of multiple age cohort vaccination and postvaccination data interpretation. J Infect Dis. 2017;216(10):1205-9.  https://doi.org/10.1093/infdis/jix476  PMID: 28968800 
  31. Fairley CK, Hocking JS, Gurrin LC, Chen MY, Donovan B, Bradshaw CS. Rapid decline in presentations of genital warts after the implementation of a national quadrivalent human papillomavirus vaccination programme for young women. Sex Transm Infect. 2009;85(7):499-502.  https://doi.org/10.1136/sti.2009.037788  PMID: 19837728 
  32. Donovan B, Franklin N, Guy R, Grulich AE, Regan DG, Ali H, et al. Quadrivalent human papillomavirus vaccination and trends in genital warts in Australia: analysis of national sentinel surveillance data. Lancet Infect Dis. 2011;11(1):39-44.  https://doi.org/10.1016/S1473-3099(10)70225-5  PMID: 21067976 
  33. Read TRH, Hocking JS, Chen MY, Donovan B, Bradshaw CS, Fairley CK. The near disappearance of genital warts in young women 4 years after commencing a national human papillomavirus (HPV) vaccination programme. Sex Transm Infect. 2011;87(7):544-7.  https://doi.org/10.1136/sextrans-2011-050234  PMID: 21970896 
  34. Ali H, Donovan B, Wand H, Read TR, Regan DG, Grulich AE, et al. Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data. BMJ. 2013;346(apr18 1):f2032.  https://doi.org/10.1136/bmj.f2032  PMID: 23599298 
  35. Ali H, Guy RJ, Wand H, Read TR, Regan DG, Grulich AE, et al. Decline in in-patient treatments of genital warts among young Australians following the national HPV vaccination program. BMC Infect Dis. 2013;13(140):140.  https://doi.org/10.1186/1471-2334-13-140  PMID: 23506489 
  36. Chow EPF, Read TRH, Wigan R, Donovan B, Chen MY, Bradshaw CS, et al. Ongoing decline in genital warts among young heterosexuals 7 years after the Australian human papillomavirus (HPV) vaccination programme. Sex Transm Infect. 2015;91(3):214-9.  https://doi.org/10.1136/sextrans-2014-051813  PMID: 25305210 
  37. Ali H, McManus H, O’Connor CC, Callander D, Kong M, Graham S, et al. Human papillomavirus vaccination and genital warts in young Indigenous Australians: national sentinel surveillance data. Med J Aust. 2017;206(5):204-9.  https://doi.org/10.5694/mja16.00597  PMID: 28301790 
  38. Larson DA, Derkay CS. Epidemiology of recurrent respiratory papillomatosis. APMIS. 2010;118(6-7):450-4.  https://doi.org/10.1111/j.1600-0463.2010.02619.x  PMID: 20553527 
  39. Novakovic D, Cheng ATL, Zurynski Y, Booy R, Walker PJ, Berkowitz R, et al. A prospective study of the incidence of juvenile-onset recurrent respiratory papillomatosis after implementation of a national HPV vaccination program. J Infect Dis. 2018;217(2):208-12. PMID: 29136168 
  40. Brotherton JML, Tabrizi SN, Phillips S, Pyman J, Cornall AM, Lambie N, et al. Looking beyond human papillomavirus (HPV) genotype 16 and 18: Defining HPV genotype distribution in cervical cancers in Australia prior to vaccination. Int J Cancer. 2017;141(8):1576-84.  https://doi.org/10.1002/ijc.30871  PMID: 28677147 
  41. Baricevic I, He X, Chakrabarty B, Oliver AW, Bailey C, Summers J, et al. High-sensitivity human papilloma virus genotyping reveals near universal positivity in anal squamous cell carcinoma: different implications for vaccine prevention and prognosis. Eur J Cancer. 2015;51(6):776-85.  https://doi.org/10.1016/j.ejca.2015.01.058  PMID: 25702585 
  42. Hillman RJ, Garland SM, Gunathilake MPW, Stevens M, Kumaradevan N, Lemech C, et al. Human papillomavirus (HPV) genotypes in an Australian sample of anal cancers. Int J Cancer. 2014;135(4):996-1001.  https://doi.org/10.1002/ijc.28730  PMID: 24497322 
  43. De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. Int J Cancer. 2009;124(7):1626-36.  https://doi.org/10.1002/ijc.24116  PMID: 19115209 
  44. Saraiya M, Unger ER, Thompson TD, Lynch CF, Hernandez BY, Lyu CW, et al. HPV Typing of Cancers Workgroup. US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. J Natl Cancer Inst. 2015;107(6):djv086.  https://doi.org/10.1093/jnci/djv086  PMID: 25925419 
  45. Antonsson A, Neale RE, Boros S, Lampe G, Coman WB, Pryor DI, et al. Human papillomavirus status and p16(INK4A) expression in patients with mucosal squamous cell carcinoma of the head and neck in Queensland, Australia. Cancer Epidemiol. 2015;39(2):174-81.  https://doi.org/10.1016/j.canep.2015.01.010  PMID: 25677091 
  46. Simms KT, Hall M, Smith MA, Lew J-B, Hughes S, Yuill S, et al. Optimal management strategies for primary HPV testing for cervical screening: cost-effectiveness evaluation for the National Cervical Screening Program in Australia. PLoS One. 2017;12(1):e0163509.  https://doi.org/10.1371/journal.pone.0163509  PMID: 28095411 
  47. Simms KT, Smith MA, Lew JB, Kitchener HC, Castle PE, Canfell K. Will cervical screening remain cost-effective in women offered the next generation nonavalent HPV vaccine? Results for four developed countries. Int J Cancer. 2016;139(12):2771-80.  https://doi.org/10.1002/ijc.30392  PMID: 27541596 
  48. Simms KT, Laprise J-F, Smith MA, Lew J-B, Caruana M, Brisson M, et al. Cost-effectiveness of the next generation nonavalent human papillomavirus vaccine in the context of primary human papillomavirus screening in Australia: a comparative modelling analysis. Lancet Public Health. 2016;1(2):e66-75.  https://doi.org/10.1016/S2468-2667(16)30019-6  PMID: 29253419 
  49. Korostil IA, Ali H, Guy RJ, Donovan B, Law MG, Regan DG. Near elimination of genital warts in Australia predicted with extension of human papillomavirus vaccination to males. Sex Transm Dis. 2013;40(11):833-5.  https://doi.org/10.1097/OLQ.0000000000000030  PMID: 24113401 
  50. Brotherton JML, Zuber PLF, Bloem PJN. Primary prevention of HPV through vaccination: update on the current global status. Curr Obstet Gynecol Rep. 2016;5(3):210-24.  https://doi.org/10.1007/s13669-016-0165-z 
  51. Mesher D, Panwar K, Thomas SL, Edmundson C, Choi YH, Beddows S, et al. The impact of the National HPV Vaccination Program in England using the bivalent HPV vaccine: surveillance of type-specific HPV in young females, 2010–2016. J Infect Dis. 2018;218(6):911-21.  https://doi.org/10.1093/infdis/jiy249  PMID: 29917082 
  52. Carozzi FM, Ocello C, Burroni E, Faust H, Zappa M, Paci E, et al. Effectiveness of HPV vaccination in women reaching screening age in Italy. J Clin Virol. 2016;84:74-81.  https://doi.org/10.1016/j.jcv.2016.09.011  PMID: 27728850 
  53. Feiring B, Laake I, Christiansen IK, Hansen M, Stålcrantz J, Ambur OH, et al. Substantial decline in prevalence of vaccine-type and non-vaccine type HPV in vaccinated and unvaccinated girls 5 years after implementing HPV vaccine in Norway. J Infect Dis. 2018.  https://doi.org/10.1093/infdis/jiy432  PMID: 30010913 
  54. Jeannot E, Viviano M, de Pree C, Amadane M, Kabengele E, Vassilakos P, et al. Prevalence of vaccine type infections in vaccinated and non-vaccinated young women: HPV-IMPACT, a self-sampling study. Int J Environ Res Public Health. 2018;15(7):E1447.  https://doi.org/10.3390/ijerph15071447  PMID: 29987255 
  55. Herweijer E, Ploner A, Sparén P. Substantially reduced incidence of genital warts in women and men six years after HPV vaccine availability in Sweden. Vaccine. 2018;36(15):1917-20.  https://doi.org/10.1016/j.vaccine.2018.02.097  PMID: 29523448 
  56. Dominiak-Felden G, Gobbo C, Simondon F. Evaluating the early benefit of quadrivalent HPV vaccine on genital warts in Belgium: a cohort study. PLoS One. 2015;10(7):e0132404.  https://doi.org/10.1371/journal.pone.0132404  PMID: 26147096 
  57. Pollock KG, Kavanagh K, Potts A, Love J, Cuschieri K, Cubie H, et al. Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland. Br J Cancer. 2014;111(9):1824-30.  https://doi.org/10.1038/bjc.2014.479  PMID: 25180766 
  58. Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, et al. Broad Spectrum HPV Vaccine Study. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372(8):711-23.  https://doi.org/10.1056/NEJMoa1405044  PMID: 25693011 
  59. Moreira ED Jr, Block SL, Ferris D, Giuliano AR, Iversen O-E, Joura EA, et al. Safety profile of the 9-valent HPV vaccine: a combined analysis of 7 phase III clinical trials. Pediatrics. 2016;138(2):e20154387.  https://doi.org/10.1542/peds.2015-4387  PMID: 27422279 
  60. Cuschieri K, Kavanagh K, Moore C, Bhatia R, Love J, Pollock KG. Impact of partial bivalent HPV vaccination on vaccine-type infection: a population-based analysis. Br J Cancer. 2016;114(11):1261-4.  https://doi.org/10.1038/bjc.2016.97  PMID: 27115467 
  61. Kreimer AR, Struyf F, Del Rosario-Raymundo MR, Hildesheim A, Skinner SR, Wacholder S, et al. Costa Rica Vaccine Trial Study Group AuthorsPATRICIA Study Group AuthorsHPV PATRICIA Principal Investigators/Co-Principal Investigator CollaboratorsGSK Vaccines Clinical Study Support Group. Efficacy of fewer than three doses of an HPV-16/18 AS04-adjuvanted vaccine: combined analysis of data from the Costa Rica Vaccine and PATRICIA Trials. Lancet Oncol. 2015;16(7):775-86.  https://doi.org/10.1016/S1470-2045(15)00047-9  PMID: 26071347 
  62. Zhai L, Tumban E. Gardasil-9: A global survey of projected efficacy. Antiviral Res. 2016;130:101-9.  https://doi.org/10.1016/j.antiviral.2016.03.016  PMID: 27040313 
  63. World Health Organization. Human papillomavirus vaccines: WHO position paper, May 2017. Wkly Epidemiol Rec. 2017;92(19):241-68. PMID: 28530369 
  64. Brotherton JM, Winch KL, Bicknell L, Chappell G, Saville M. HPV vaccine coverage is increasing in Australia. Med J Aust. 2017;206(6):262.  https://doi.org/10.5694/mja16.00958  PMID: 28359009 
  65. Brotherton JM, Murray SL, Hall MA, Andrewartha LK, Banks CA, Meijer D, et al. Human papillomavirus vaccine coverage among female Australian adolescents: success of the school-based approach. Med J Aust. 2013;199(9):614-7.  https://doi.org/10.5694/mja13.10272  PMID: 24182228 
  66. Marshall H, Ryan P, Roberton D, Baghurst P. A cross-sectional survey to assess community attitudes to introduction of Human papillomavirus vaccine. Aust N Z J Public Health. 2007;31(3):235-42.  https://doi.org/10.1111/j.1467-842X.2007.00054.x  PMID: 17679241 
  67. Marshall HS, Collins J, Sullivan T, Tooher R, O’Keefe M, Skinner SR, et al. Parental and societal support for adolescent immunization through school based immunization programs. Vaccine. 2013;31(30):3059-64.  https://doi.org/10.1016/j.vaccine.2013.04.064  PMID: 23664996 
  68. National Statistics. HPV immunisation statistics Scotland - school year 2015/16. Glasgow: National Services Scotland; 2016. Available from: https://www.isdscotland.org/Health-Topics/Child-Health/Publications/2016-11-08/2016-11-08-HPV-Immunisation-Report.pdf
  69. Brisson M, Bénard É, Drolet M, Bogaards JA, Baussano I, Vänskä S, et al. Population-level impact, herd immunity, and elimination after human papillomavirus vaccination: a systematic review and meta-analysis of predictions from transmission-dynamic models. Lancet Public Health. 2016;1(1):e8-17.  https://doi.org/10.1016/S2468-2667(16)30001-9  PMID: 29253379 
  70. Stevens MP, Garland SM, Tan JH, Quinn MA, Petersen RW, Tabrizi SN. HPV genotype prevalence in women with abnormal pap smears in Melbourne, Australia. J Med Virol. 2009;81(7):1283-91.  https://doi.org/10.1002/jmv.21515  PMID: 19475612 
  71. Garland SM, Brotherton JML, Skinner SR, Pitts M, Saville M, Mola G, et al. Human papillomavirus and cervical cancer in Australasia and Oceania: risk-factors, epidemiology and prevention. Vaccine. 2008;26(Suppl 12):M80-8.  https://doi.org/10.1016/j.vaccine.2008.05.041  PMID: 18945417 
  72. Callegari ET, Tabrizi SN, Pyman J, Saville M, Cornall AM, Brotherton JM, et al. How best to interpret mixed human papillomavirus genotypes in high-grade cervical intraepithelial neoplasia lesions. Vaccine. 2014;32(32):4082-8.  https://doi.org/10.1016/j.vaccine.2014.05.041  PMID: 24857693 
  73. Antonsson A, Wilson LF, Kendall BJ, Bain CJ, Whiteman DC, Neale RE. Cancers in Australia in 2010 attributable to infectious agents. Aust N Z J Public Health. 2015;39(5):446-51.  https://doi.org/10.1111/1753-6405.12445  PMID: 26437730 
  74. Australian Institute of Health and Welfare (AIHW). Cancer in Australia: an overview, 2012. Canberra: AIHW; 2012. Available from; https://www.aihw.gov.au/reports/cancer/cancer-in-australia-an-overview-2012/contents/table-of-contents
  75. Australian institute of Health and Welfare (AIHW). Gynaecological cancers in Australia: an overview. Canberra: AIHW; 2012. Available from: https://www.aihw.gov.au/reports/cancer/gynaecological-cancers-in-australia-an-overview/contents/summary
/content/10.2807/1560-7917.ES.2018.23.41.1700737
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error