Impact of Prophylactic HPV Vaccination on the Prevention of HPV-Driven Oral Cancers in India: Current Progress and Future Perspectives

Human Papillomavirus (HPV) is the most prevalent sexually transmitted infection (STI) globally and contributor to a significant proportion of infection-related cancers, including oral squamous cell carcinomas (OSCCs). Persistent infection with oncogenic HPV strains is increasingly recognized as a critical cause of oral cancers, particularly in India. While HPV infections are often asymptomatic and transient, those that persist for year or more can lead to malignancies following integration into host cell genome and disrupting tumor-suppressor genes. HPV vaccination, including vaccines such as Cervarix, Gardasil or Gardasil-9, and the more recently introduced CERVAVAC in India, has significantly reduced the incidence of cervical and other HPV-related anogenital cancers. However, the potential of these vaccines in preventing HPV-linked OSCCs remains underexplored, especially in the Indian context, where the incidence of these cancers, particularly among younger populations, is on the rise. This review critically examines the role of HPV vaccination in preventing HPV-associated OSCCs. It explores the biological mechanisms by which HPV contributes to oral carcinogenesis, focusing on the most common HPV strains linked to these cancers. The review also assesses the effectiveness of existing HPV vaccines in preventing oral-HPV infections, drawing on the latest epidemiological and clinical studies. Despite promising evidence supporting the efficacy of HPV vaccines, challenges such as low vaccine uptake, limited public awareness, and socio-economic barriers hinder their widespread adoption in low-income countries including India. This review also discusses the early outcomes of vaccination programs on OSCC incidence and discusses strategies to enhance vaccine coverage, including targeted public health initiatives and policy interventions. By addressing these gaps, this review aims to provide a comprehensive understanding of the potential impact of HPV vaccination in reducing the burden of HPV-associated oral cancers in India and offering insights for future research and public health strategies.