Cervical Cancer Screening Should be Individualized for Women Vaccinated Against High-Risk HPV
By Ramadhani Chambuso
Appropriate cervical cancer screening intervals for women vaccinated against high-risk HPV are yet to be well established and an updated screening algorithm has not been agreed worldwide.
However, a recent simulation study done in England found that the necessary number of lifetime screens for HPV16/18-vaccinated women and HPV16/18/31/33/45/52/ 58-vaccinated women were three for cervical cancer prevention in HPV16/18-vaccinated women, while just two for HPV16/18/31/33/45/52/58-vaccinated women.
Furthermore, these researchers used a microsimulation model calibrated to real published data to determine the appropriate screening intensity for vaccinated women. As well the natural histories in the absence of vaccination were simulated for 300,000 women using 10,000 sets of transition probabilities.
In addition, the linkage of vaccination status to the screening programme was done, a process already recommended earlier in England. For example, the current US guidelines recommend the same screening intervals for women regardless of vaccination status, though this is likely to be updated once vaccinated women enter screening and the data have been evaluated. Assuming future cervical screening guidelines differ for vaccinated and unvaccinated women, countries which do not have a good record of who received the HPV vaccine may wish to consider the potential use of HPV antibody testing as part of a future cervical screening programme.
Therefore, these results clearly demonstrate that the cervical cancer screening programme should be personalised based on HPV vaccination status.
Source link: Landy et al. (2017).