Long-term cervical cancer prevention strategies across the globe.
Worldwide, there are several approaches for the prevention of cervical cancer, and in the near future it is likely that human papillomavirus (HPV) vaccination and HPV-based screening will be complementary strategies. In the US, professional guidelines on HPV screening recommend a co-testing approach utilizing HPV DNA testing and cytology in women aged ≥30 years. However, a growing body of evidence indicates that HPV testing is more sensitive than cytology, suggesting that HPV DNA testing may be more useful as the sole primary screening modality, especially for newly implemented programs. HPV vaccination programs targeted at young girls have been widely implemented in several affluent countries, and currently available data confirm the long-term efficacy of the VLP-based vaccines against HPV-related disease over periods of up to 8 years. If these HPV vaccines continue to demonstrate sustained and durable efficacy, less frequent screening may become a reality, but screening will continue to play an important role in providing protection for disease caused by types not included in these vaccines. However, a significant HPV vaccination-induced reduction in cervical cancer burden is not likely to be realized for at least 10 to 15 years.
Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Queen Mary University of London, Wolfson Institute of Preventive Medicine, UK. j.cuzick@qmul.ac.uk
Jack
J
Cuzick
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D055815:Young Adult