Cervical cancer: how often should vaccinated women be screened?

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Women who receive HPV vaccination may require as few as 2 cervical screens during their lives, according to research carried out by Queen Mary University of London.

The study, published in the International Journal of Cancer, simulated natural histories for 300,000 women using 10,000 sets of transition probabilities. To benchmark cost-benefits of screening for vaccinated women, the researchers evaluated the proportion of cancers prevented per additional screen (incremental benefit) of current cytology and likely HPV screening scenarios in unvaccinated women.

They found that slightly more cancers were prevented through vaccination with no screening (70.3%) than realistic compliance to the current UK screening programme in the absence of vaccination (64.3%). In HPV16/18-vaccinated women, the incremental benefit of offering a third lifetime screen was at most 3.3%, with an incremental benefit of 1.3% for a fourth screen. For HPV16/18/31/33/45/52/58-vaccinated women, 2 lifetime screens were supported.

The authors concluded that 3 screens at 30, 40, and 55 y of age would offer the same benefit to vaccinated women as the 12 lifetime screens currently offered in England.

Since 2008, the HPV vaccine has been offered to schoolgirls aged 11-13 y across the United Kingdom. This group is now reaching the age for their first cervical screening invitation. This new research shows that these women can still be effectively protected from cervical cancer with fewer screens, which could also save the NHS resources.