Statement of the Expert Group of Polish Gynecologic Society on the cervical adenocarcinoma prophylaxis

Abstract

The group of experts representing the Polish Gynecologic Society has issued this Statement based on the review of available literature on the epidemiology of cervical adenocarcinoma and the most effective methods of its prophylaxis. Although the incidence of squamous cell cervical carcinomas has declined in the last 30 years, that of cervical adenocarcinoma has significantly increased in recent years, especially among young women. This rise in incidence obviously results from the fact that routinely used screening methods such as Pap test fail to detect a substantial proportion of the glandular precursor lesions. HPV infection constitutes the key risk factor for cervical adenocarcinoma. Three most prevalent HPV types (16,18 and 45) account for 92% of cases of cervical adenocarcinoma. From the point of view of the adenocarcinoma prophylaxis, it is important that a significant cross-protection against persistent infection with HPV type 45 has been shown for the bivalent HPV vaccine. It has been estimated that the protective efficacy of the HPV vaccination with respect to the cervical adenocarcinoma exceeds that regarding squamous tumors by nearly 20%. Large-scale implementation of HPV vaccination with the vaccines that target the most predominant virus types associated with cervical adenocarcinoma seems to be the most effective way to reduce both the incidence and mortality rates of this cancer.