The initial indication was for adolescent and young adult females (age range 9 to 26), preferably starting before sexarche.
Areas of discussion:
(1) need to vaccinate males
(2) patients with existing HPV lesions (to reduce recurrence)
(3) older sexually-active adult (to reduce spread of different types)
Decision modifiers:
(1) poor access to health screening
(2) male who has sex with males (MSM)
(3) large number of sexual contacts
(4) cost of the vaccination program
Sites of preventable malignancies:
(1) genital (condylomata, dysplasia and squamous cell carcinoma)
(2) anal (associated with receptive anal intercourse)
(3) oropharyngeal, tonsillar and upper respiratory tract
(4) other
