The recent US Food and Drug Administration licensure of a prophylactic
vaccine against oncogenic human papillomavirus (HPV) types 16 and 18, the first of its kind, poses unique challenges in postmarketing
vaccine surveillance, especially in measuring
vaccine effectiveness against biologic endpoints of
HPV infection. Historically, the national system of population-based
cancer registries in the US has provided high-quality data on
cancer incidence and mortality for the most important biologic endpoints, namely, anogenital
cancers and some oral cavity/
oropharyngeal cancers. There also has been some data collection on
cancer precursors; however, this activity has been inconsistent and of lower priority. Because effectiveness against HPV-associated
cancers will not be measurable for several decades, strengthening and possibly expanding the capacity of registries to collect precancer data, which are earlier manifestations of
infection, must be considered. Collecting type-specific data on HPV-associated precancers and
cancers. While keeping in mind the current limitations of registry operations, they discuss resources that may be needed to implement and sustain these types of activities.