TY - JOUR
T1 - HPV-FASTER
T2 - broadening the scope for prevention of HPV-related cancer
AU - Bosch, F Xavier
AU - Robles, Claudia
AU - Díaz, Mireia
AU - Arbyn, Marc
AU - Baussano, Iacopo
AU - Clavel, Christine
AU - Ronco, Guglielmo
AU - Dillner, Joakim
AU - Lehtinen, Matti
AU - Petry, Karl-Ulrich
AU - Poljak, Mario
AU - Kjaer, Susanne K
AU - Meijer, Chris J L M
AU - Garland, Suzanne M
AU - Salmerón, Jorge
AU - Castellsagué, Xavier
AU - Bruni, Laia
AU - de Sanjosé, Silvia
AU - Cuzick, Jack
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Human papillomavirus (HPV)-related screening technologies and HPV vaccination offer enormous potential for cancer prevention, notably prevention of cervical cancer. The effectiveness of these approaches is, however, suboptimal owing to limited implementation of screening programmes and restricted indications for HPV vaccination. Trials of HPV vaccination in women aged up to 55 years have shown almost 90% protection from cervical precancer caused by HPV16/18 among HPV16/18-DNA-negative women. We propose extending routine vaccination programmes to women of up to 30 years of age (and to the 45-50-year age groups in some settings), paired with at least one HPV-screening test at age 30 years or older. Expanding the indications for HPV vaccination and much greater use of HPV testing in screening programmes has the potential to accelerate the decline in cervical cancer incidence. Such a combined protocol would represent an attractive approach for many health-care systems, in particular, countries in Central and Eastern Europe, Latin America, Asia, and some more-developed parts of Africa. The role of vaccination in women aged >30 years and the optimal number of HPV-screening tests required in vaccinated women remain important research issues. Cost-effectiveness models will help determine the optimal combination of HPV vaccination and screening in public health programmes, and to estimate the effects of such approaches in different populations.
AB - Human papillomavirus (HPV)-related screening technologies and HPV vaccination offer enormous potential for cancer prevention, notably prevention of cervical cancer. The effectiveness of these approaches is, however, suboptimal owing to limited implementation of screening programmes and restricted indications for HPV vaccination. Trials of HPV vaccination in women aged up to 55 years have shown almost 90% protection from cervical precancer caused by HPV16/18 among HPV16/18-DNA-negative women. We propose extending routine vaccination programmes to women of up to 30 years of age (and to the 45-50-year age groups in some settings), paired with at least one HPV-screening test at age 30 years or older. Expanding the indications for HPV vaccination and much greater use of HPV testing in screening programmes has the potential to accelerate the decline in cervical cancer incidence. Such a combined protocol would represent an attractive approach for many health-care systems, in particular, countries in Central and Eastern Europe, Latin America, Asia, and some more-developed parts of Africa. The role of vaccination in women aged >30 years and the optimal number of HPV-screening tests required in vaccinated women remain important research issues. Cost-effectiveness models will help determine the optimal combination of HPV vaccination and screening in public health programmes, and to estimate the effects of such approaches in different populations.
U2 - 10.1038/nrclinonc.2015.146
DO - 10.1038/nrclinonc.2015.146
M3 - Journal article
C2 - 26323382
SN - 1759-4774
VL - 13
SP - 119
EP - 132
JO - Nature Reviews Clinical Oncology
JF - Nature Reviews Clinical Oncology
IS - 2
ER -