Advancing comprehensive prevention of HPV-related diseases across populations and multiple disease types
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Human papillomavirus (HPV) infection has long been considered a primary causative factor for cervical cancer, but its significant role in a range of non-cervical cancers and diseases is increasingly recognised. Globally, the incidence of HPV-related non-cervical diseases such as vulvar, vaginal, anal, and head and neck cancers continues to rise.1 In China, new cases of HPV-related cancers increased by 3.8% annually from 2007 to 2015, with anal and oropharyngeal cancers in males rising markedly.2 Effective interventions are urgently needed to curb this growing disease burden. In August 2025, the ‘Expert Consensus on the Early Prevention of Human Papillomavirus-Related Non-Cervical Diseases (2025 Edition)’ was jointly released by the Cancer Prevention and Control Committee and the Vaccine and Immunization Branch of the Chinese Preventive Medicine Association. By outlining evidence-based strategies for health education, vaccination and targeted screening, the Consensus shifts the national strategy from a cervical-focused approach towards a comprehensive, ‘multi-disease’ and ‘gender-neutral’ prevention framework. This transition aligns China with global best practices transitions and inaugurates a new era of comprehensive HPV control.3
A paradigm shift in core concept: from female-specific cancer prevention to gender-neutral, multi-disease prevention
The release of this Consensus holds significant practical importance. While a mature system for cervical cancer prevention is already established in China4 5, public awareness of HPV-related diseases in other anatomical sites remains limited, and clinical management lacks standardised guidance. To address this gap, the Consensus synthesises the latest domestic and international evidence to provide a comprehensive overview of the etiology, epidemiology and disease burden of non-cervical HPV-related diseases. It culminates in 13 specific recommendations, spanning both primary and secondary prevention, serving as a scientific foundation to guide clinical practice, public health initiatives and policymaking (table 1).
Table 1
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Summary of core recommendations for early prevention of HPV-related non-cervical diseases
The Consensus introduces the strategic concept of ‘multi-disease joint prevention and gender-neutral prevention’. This represents a paradigm shift from a cervical cancer to one that encompasses a broad spectrum of HPV-related diseases—including vulvar, vaginal, penile, anal, and head and neck cancers, as well as genital warts and respiratory papillomatosis (RRP). Furthermore, it emphasises that men are not merely links in the chain of HPV transmission but are also direct victims of various HPV-related diseases.6 7 These conceptual evolutions help to expand China’s HPV control strategy to include both cervical cancer and other related diseases within a unified public health framework.8–11
Precision in prevention and control strategies: for specific diseases and high-risk populations
The Consensus outlines recommendations for various HPV-related non-cervical diseases, combining shared common foundational elements with disease-specific priorities. For primary prevention, HPV vaccination serves as the universal cornerstone, complemented by health education, safe sexual practices, smoking cessation, alcohol moderation and personal hygiene.10 Guided by available evidence, the Consensus further recommends vaccination for vulvar, vaginal, anal and head and neck cancers, as well as genital wart prevention supported by Grade A evidence. In contrast, the recommendation for vaccinating against penile cancer and RRP is based on lower evidence grades.
Regarding screening, the Consensus advises against universal population screening due to cost-effectiveness concerns, instead advocating for targeted approaches in high-risk populations.12–14 Specific strategies include concurrent examination for vulvar and vaginal cancers during cervical cancer screening; anal cytology and HPV testing for high-risk individuals such as men who have sex with men and people living with HIV; risk reduction through smoking cessation and alcohol moderation for head and neck cancers, supplemented by endoscopic early diagnosis; ancillary diagnostic tests for atypical genital warts in high-risk individuals and flexible laryngopharyngoscopy for children with persistent or progressive hoarseness, especially accompanied by stridor or respiratory difficulty, when clinically indicated and vital signs are stable.3 This evidence-informed, disease-specific and population-focused framework marks a pivotal shift from a one-size-fits-all screening towards precision prevention.
Bridging policy and practice: catalysing action from consensus
The release of the Consensus coincides with a critical period in China’s inclusion of HPV vaccines in the national immunization programme (NIP).15 While current immunization strategies focus on cervical cancer prevention, the Consensus systematically summarises evidence for HPV vaccination in preventing non-cervical diseases. This contributes to raising awareness among the public and healthcare professionals regarding the broader spectrum of diseases preventable by HPV vaccination, thereby facilitating the further implementation of vaccination policies.
Notably, the Consensus proposes the concept of ‘gender-neutral prevention’, advocating for the inclusion of males in HPV vaccination efforts. Current NIP primarily targets females, and widespread dissemination of this Consensus is expected to boost female vaccination rates. This will not only help build herd immunity but also lay a practical foundation for potentially expanding vaccination to males in the future.10 International experience from Australia and the UK shows that after achieving high coverage in females, male vaccination initiatives can be effectively implemented. This coordinated promotion strategy is anticipated to increase HPV vaccination rates among all genders and reduce the overall burden of HPV-related diseases.16–18 In the area of secondary prevention, the Consensus offers clinical guidance for healthcare providers and also supports public health policymaking. For instance, its recommendations on anal cancer screening in high-risk populations provide critical support for enhancing China’s comprehensive HPV control strategy.
Future directions: building a comprehensive prevention and control system
The Consensus prospectively outlines four strategic priorities that serve as a roadmap for future work. First, establishing a targeted, multi-channel public health education system to improve awareness of HPV infection risks, particularly among males;11 second, enhancing vaccination infrastructure and accessibility to ensure effective policy execution and generating robust evidence on vaccine efficacy and cost-effectiveness within the Chinese population to scientifically inform policy evolution and the expansion of vaccine indications; third, developing tailored screening tools and a full process service model for the identification, follow-up and management of high-risk populations for HPV infection and related diseases.
As a milestone in China’s transition towards comprehensive HPV prevention, this Consensus provides a scientific foundation and an actionable framework for the national strategy. It bridges global best practices and local realities through multi-stakeholder collaboration, thereby translating evidence into practice, reducing the disease burden and contributing China’s unique experience to the global efforts.
Contributors: XZ and FZ planned, conducted and modified this article. FZ is the guarantor.
Funding: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2021‑I2M‑1‑004).
Competing interests: None declared.
Patient and public involvement: Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Provenance and peer review: Not commissioned; externally peer reviewed.
Data availability statement
No data are available.
Ethics statements
Patient consent for publication:
Not applicable.
Ethics approval:
Not applicable.
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