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December 28, 2018

Requiring Human Papilloma Virus Vaccination for School Entry

Author Affiliations
  • 1Harvard Medical School, Boston, Massachusetts
  • 2O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC
JAMA Pediatr. Published online December 28, 2018. doi:10.1001/jamapediatrics.2018.4283

The Centers for Disease Control and Prevention (CDC) estimates that 41 000 people are diagnosed as having a human papilloma virus (HPV)–associated cancer each year, amounting to almost 2.5% of all new cancer diagnoses.1 For men, the most common associated cancer is oropharyngeal cancer, and for women, it is cervical cancer. More than 250 000 women in the United States live with cervical cancer, and one-third will die within 5 years of diagnosis.2 The incidence of cervical cancer has declined considerably since the development of Papanicolaou test screening, but the percentage of women undergoing Papanicolaou tests has decreased since 2000. Furthermore, screening has been inequitably distributed across populations; women insured through Medicaid or without health coverage and women with lower education levels are screened at lower rates.3 Screening for other HPV-associated cancers such as oropharyngeal cancer, anal cancer, vaginal cancer, vulvar cancer, and penile cancer is much less robust. Thus, while screening is an effective prevention tool, the ultimate public health success would be to prevent HPV infection altogether.

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