Predicting the effect of successful human papillomavirus vaccination on existing cervical cancer prevention programs in the United States

The development of a prophylactic human papillomavirus (HPV) vaccine that potentially may eliminate a majority of cervical cancers is a landmark in cancer prevention. Cervical screening, however, will continue to play an important role for the foreseeable future. Maintaining screening at the same intensity and simply adding on the expense of vaccination would result in redundancy of prevention efforts at enormously increased costs without necessarily further reducing cervical cancer mortality. Effectively integrating vaccination and screening efforts will be a critical and evolving challenge over the next decade; this will require understanding not only the impact of vaccination on reducing cervical abnormalities but also the influence of vaccination on screening test performance.