Peer-reviewed article
Elimination of HPV-associated cancers: universal HPV vaccination and the role of anal screening – a meeting report
F. Ricardo Burdier, Laia Bruni, Anna R. Giuliano, Nelly R. Mugo, Kirsty Roy et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This is a report of a technical meeting held in Antwerp, Belgium, in June 2025. It reviewed evidence on giving HPV vaccine to everyone (not only girls) and on screening for anal cancer. The meeting concluded that universal vaccination is justified on grounds of equity, programme resilience, less vaccine hesitancy and prevention of cancers other than cervical cancer. It also concluded that targeted anal cancer screening deserves immediate attention for high-risk groups. Country experiences from Scotland and Cameroon showed persistent equity gaps and the importance of community engagement.
Key points
- HPV causes about 148,072 cancer cases in men each year worldwide, likely an undercount.
- Community-randomised trial evidence shows universal vaccination gives stronger herd protection than girls-only vaccination and may speed elimination of the most cancer-causing HPV types within 15-30 years.
- Modelling identifies high coverage in girls as the most efficient strategy for cervical cancer elimination, but universal vaccination is justified on broader public health grounds.
- The ANCHOR trial found that treating anal high-grade lesions reduces anal cancer incidence by 57%.
- Anal screening is constrained by limited high-resolution anoscopy capacity, workforce shortages, stigma and limited evidence on the best screening methods.
Limitations
This is a meeting report summarising existing evidence, not a new study, and the abstract gives no detail on the Cameroon or Scotland experiences. Much of the content concerns adult screening and cancer, and the abstract does not say which age groups or child-specific vaccination outcomes were discussed.
Abstract
The HPV Prevention and Control Board convened its 18th technical meeting in Antwerp, Belgium (June 2025) to review the evidence on universal HPV vaccination and the role of anal cancer screening in the elimination of HPV-associated cancers. While HPV prevention has historically focused on cervical cancer in women, growing evidence supports extending both primary and secondary prevention to male cohorts and non-cervical anatomical sites. HPV causes approximately 148,072 cancer cases in men annually in the world - likely a substantial undercount - affecting primarily the oropharynx, anus, and penis. Men's lower seroconversion rates after natural HPV infection and sustained HPV prevalence across age groups makes vaccination an essential tool to prevent HPV-related disease in this population. Community-randomised trial evidence confirms that universal vaccination delivers stronger herd protection than girls-only strategies and may accelerate elimination of the most oncogenic types within 15-30 years. While modelling analyses identify high coverage in girls as the most efficient strategy for cervical cancer elimination, universal vaccination is justified on broader public health grounds, including equity, programme resilience, reduced vaccine hesitancy, and prevention of non-cervical cancers. Country experiences from Scotland and Cameroon highlight persistent equity gaps and the critical role of community engagement. Given the direct epidemiological link between HPV infection in males - particularly gay, bisexual, and other men who have sex with men and immunocompromised populations, such as people living with HIV - and anal cancer risk, the meeting identified anal cancer screening as the most advanced non-cervical secondary prevention strategy warranting immediate attention. The ANCHOR trial demonstrated that treating anal high-grade squamous intraepithelial lesions reduces anal cancer incidence by 57%. Despite the publication of the first evidence-based U.S. Health and Human Services and International Anal Neoplasia Society guidelines in 2024, implementation remains constrained by high-resolution anoscopy capacity, workforce shortages, stigma, and limited evidence on optimal screening algorithms. The meeting concluded that integrating universal vaccination with targeted anal cancer screening - supported by equitable access, biomarker development, and living guidelines that evolve with emerging evidence - is essential to reducing HPV-related cancer burden in both women and men.