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    Contents lists available at ScienceDirect
    Papillomavirus Research
    journal homepage:
    Burden of Human papillomavirus (HPV)-related disease and potential impact of HPV vaccines in 186689-07-6 the Republic of Korea 
    Young-Tak Kima,1, Beatriz Serranob,f,1, Jae-Kwan Leec, Hyunju Leed, Shin-Wha Leea, Crystal Freemanb, Jin-Kyoung Ohe, Laia Alemanyb,g, Francesc-Xavier Boschb,f, Laia Brunib,f, a Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea b Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO) – Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain c Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea d Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea e Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy; National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea f Centro de Investigacion Biomédica en Red de Cancer (CIBERONC), Madrid, Spain g Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
    Human papillomavirus
    Republic of Korea
    Papillomavirus vaccine
    Cervical cancer screening 
    Background: We aimed to review the burden and the potential impact of human papillomavirus (HPV) vaccines on HPV-related diseases in the Republic of Korea and to discuss cervical cancer prevention practices in this country.
    Methods: Cancer burden statistics were retrieved from GLOBOCAN-2018 and Statistics Korea. HPV disease burden was assessed via systematic review. Vaccine types relative contribution (RC) was estimated using data from an international project using formalin-fixed paraffin-embedded specimens.
    Results: Despite a downtrend in cervical cancer in recent years, Korean rates remain high. In contrast, or-opharyngeal cancer incidence has gradually increased and other anogenital cancers remain rare.
    In Korea, HPV prevalence in general population is around 20%. In cervical cancer, RC of HPVs 16/18 (74.0%) increased to 92.0% when including HPVs 31/33/45/52/58. Limited information was available for other HPV-related cancer sites. Regarding prevention, since the inclusion of the HPV vaccine into the National Immunization Program, al-most half (49%) of the target cohort in 2016 had received the first dose of vaccine. Further, percentage of women screened with pap has increased from 41.1%-2009 to 53.0%-2016. Conclusions: HPV-related disease burden in Korea is significant. Results suggest that the combination of effective and high coverage HPV vaccination and screening programmes could substantially impact on HPV-related disease in Korea.
    1. Introduction
    Cancer is the leading cause of death in the Republic of Korea (hereinafter also referred to as Korea) and was responsible for 28.1% of all deaths in 2017 [1]. In Korea, more than 277,000 new cancer cases more than 86,000 new cancer deaths are reported annually (estimates for 2018) [2]. Further, cancer burden is expected to increase in Korea
    with an aging population and westernized lifestyles.
    Human papillomavirus (HPV) infection is an important contributor to cancer-related morbidity and mortality in the country, accounting for 11.3% of new infection-related cancer cases and 6.0% of infection-re-lated cancer deaths in 2007 [3]. Although the majority of HPV infec-tions (70–90%) do not cause symptoms and resolve spontaneously within 2 years, persistent infection with oncogenic HPV types, also