The impact of human papillomavirus vaccination on cervical cancer prevention efforts

L. Stewart Massad, Mark Einstein, Evan Myers, Cosette M. Wheeler, Nicolas Wentzensen, Diane Solomon

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objectives: To review concepts, information, obstacles, and approaches to cervical cancer screening and prevention as vaccination against human papillomavirus (HPV) types 16 and 18 is adopted. Methods: Expert forum, conducted September 12-13, 2008, hosted by the Society of Gynecologic Oncologists, including 56 experts in cervical cancer and titled Future Strategies of Cervical Cancer Prevention: What Do We Need to Do Now to Prepare? Results: The current approach to cervical cancer screening in the U.S. is limited by its opportunistic nature. If given to women before exposure, a vaccine against HPV 16,18 can decrease cervical cancer risk by up to 70%. The impact on abnormal cytology and cervical intraepithelial neoplasia (CIN) will be less but still substantial. As the prevalence of high-grade CIN falls, fewer women with positive screening tests will have truly preinvasive disease. To minimize harm from false positive tests in women who are at low risk for cancer because of early vaccination, later initiation of and longer intervals between screenings are ideal. However, the vaccine is less effective when administered after first intercourse, and delivering and documenting HPV vaccination to girls at optimal ages may prove difficult. Conclusions: Until population-based data on the performance of cytology, HPV testing, and alternate screening or triage interventions become available, modifying current screening guidelines is premature. Current recommendations to initiate screening as late as age 21 and to screen less often than annually are appropriate for young women known to have been vaccinated before first intercourse.

Original languageEnglish (US)
Pages (from-to)360-364
Number of pages5
JournalGynecologic Oncology
Volume114
Issue number2
DOIs
StatePublished - Aug 2009

Fingerprint

Uterine Cervical Neoplasms
Vaccination
Human papillomavirus 18
Cervical Intraepithelial Neoplasia
Human papillomavirus 16
Coitus
Early Detection of Cancer
Cell Biology
Vaccines
Triage
Guidelines
Population
Neoplasms

Keywords

  • Cervical cancer prevention
  • HPV epidemiology
  • HPV vaccine
  • Human papillomavirus (HPV)
  • Test accuracy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Massad, L. S., Einstein, M., Myers, E., Wheeler, C. M., Wentzensen, N., & Solomon, D. (2009). The impact of human papillomavirus vaccination on cervical cancer prevention efforts. Gynecologic Oncology, 114(2), 360-364. https://doi.org/10.1016/j.ygyno.2009.04.005

The impact of human papillomavirus vaccination on cervical cancer prevention efforts. / Massad, L. Stewart; Einstein, Mark; Myers, Evan; Wheeler, Cosette M.; Wentzensen, Nicolas; Solomon, Diane.

In: Gynecologic Oncology, Vol. 114, No. 2, 08.2009, p. 360-364.

Research output: Contribution to journalArticle

Massad, LS, Einstein, M, Myers, E, Wheeler, CM, Wentzensen, N & Solomon, D 2009, 'The impact of human papillomavirus vaccination on cervical cancer prevention efforts', Gynecologic Oncology, vol. 114, no. 2, pp. 360-364. https://doi.org/10.1016/j.ygyno.2009.04.005
Massad LS, Einstein M, Myers E, Wheeler CM, Wentzensen N, Solomon D. The impact of human papillomavirus vaccination on cervical cancer prevention efforts. Gynecologic Oncology. 2009 Aug;114(2):360-364. https://doi.org/10.1016/j.ygyno.2009.04.005
Massad, L. Stewart ; Einstein, Mark ; Myers, Evan ; Wheeler, Cosette M. ; Wentzensen, Nicolas ; Solomon, Diane. / The impact of human papillomavirus vaccination on cervical cancer prevention efforts. In: Gynecologic Oncology. 2009 ; Vol. 114, No. 2. pp. 360-364.
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