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Vaccine. 2013 Dec 31;31 Suppl 7:H46-58. doi: 10.1016/j.vaccine.2013.06.043.

Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Russian Federation, the Western countries of the former Soviet Union, Caucasus region and Central Asia.

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Department of Obstetrics and Gynecology, Russian Medical Academy of Post-graduate Education, Moscow, Russia. Electronic address:
Department of Clinical Laboratory Diagnostics, Russian Medical Academy of Post-graduate Education, Moscow, Russia.
Department of Epidemiology, IM Sechenova Moscow Medical University, Moscow, Russia.
Department of Obstetrics and Gynecology, Moscow Medical University, Moscow, Russia.
Department of Obstetrics and Gynecology, Russian Medical Academy of Post-graduate Education, Moscow, Russia.
Laboratory PCR Department, Central Institute of Epidemiology, Moscow, Russia.
Research Centre of Obstetrics and Gynecology of Ministry of Health, Tashkent, Uzbekistan.
Department of Oncogynecology, Research Centre of Oncology of Ministry of Health, Minsk, Belarus.
Institut d'Investigació Biomèdica de Bellvitge - Bellvitge Biomedical Research Institute (IDIBELL), Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Program (CERP), Institut Català d'Oncologia - Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.
Centre for Cancer Registry Data, Robert Koch-Institute, Berlin, Germany.
Department of International Health, University of Copenhagen, Copenhagen, Denmark.
Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium; Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium.
Department of Oral Pathology and Oral Radiology, Institute of Dentistry and Medicine Research Laboratory, University of Turku, Turku, Finland.
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.


Limited data are available on the burden of human papillomavirus (HPV) and its associated diseases in the Russian Federation, the Western Countries of the former Soviet Union (Belarus, Republic of Moldova, Ukraine), the Caucasus region and Central Asia (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan). Both the incidence and mortality rate of cervical cancer are higher in these countries than in most Western European countries. In this article, we review available data on HPV prevalence and type distribution in women with normal cytology, women from the general population, cervical precancerous lesions and cervical cancer, as well as data on national policies of cervical cancer screening and HPV vaccination initiatives in these countries. Based on scarce data from the 12 countries, the high-risk HPV (hrHPV) prevalence among 5226 women with normal cytology ranged from 0.0% to 48.4%. In women with low-grade cervical lesions, the hrHPV prevalence among 1062 women varied from 29.2% to 100%. HrHPV infection in 565 women with high-grade cervical lesions ranged from 77.2% to 100% and in 464 invasive cervical cancer samples from 89.8% to 100%. HPV16 was the most commonly detected hrHPV genotype in all categories. As the HPV genotype distribution in cervical diseases seems to be similar to that found in Western Europe the implementation of HPV testing in screening programs might be beneficial. Opportunistic screening programs, the lack of efficient call-recall systems, low coverage, and the absence of quality assured cytology with centralized screening registry are major reasons for low success rates of cervical cancer programs in many of the countries. Finally, HPV vaccination is currently not widely implemented in most of the twelve countries mainly due to pricing, availability, and limited awareness among public and health care providers. Country-specific research, organized nationwide screening programs, registries and well defined vaccination policies are needed. This article forms part of a Regional Report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region" Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.


Caucasus region; Central Asia; Cervical cancer; Eastern Europe; HPV; HPV vaccination; Screening

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