Cervical screening adherence in the era of HPV vaccination: how low is too low?

Date

2009-09-21

Authors

Bauch, Chris T.
Li, Meng
Chapman, Gretchen
Galvani, Alison P.

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier

Abstract

The recently licensed human papillomavirus (HPV) vaccine prevents infection by two major oncogenic HPV types. However, continued screening in vaccinated women is necessary to prevent cancers caused by high-risk types not included in the vaccine. In the vaccine era, there is new concern that vaccinated women will reduce their rate of screening due to an exaggerated sense of protection from the vaccine. Some have suggested this could paradoxically lead to an increase in the incidence of cervical cancer. Here, we present a simple mathematical model suggesting that this outcome is unlikely. This result applies under a wide range of possible vaccine coverage levels and screening programme effectiveness. In populations that currently have highly effective cervical screening programmes, screening rates in vaccinated women have less room to fall before cervical cancer incidence starts to increase in the vaccine era, although the required declines are still very steep.

Description

Keywords

HPV, screening, vaccination, cervical cancer, cervical screening programmes

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