HPV-FASTER: broadening the scope for prevention of HPV-related cancer.
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.
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d' Oncologia-Catalan Institute of Oncology, IDIBELL, Avenida Gran Via 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
F Xavier
FX
Bosch
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d' Oncologia-Catalan Institute of Oncology, IDIBELL, Avenida Gran Via 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
Claudia
C
Robles
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d' Oncologia-Catalan Institute of Oncology, IDIBELL, Avenida Gran Via 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
Mireia
M
Díaz
Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium.
Marc
M
Arbyn
International Agency for Research on Cancer, Lyon, France.
Iacopo
I
Baussano
Centre Hospitalier Universitaire (CHU) Reims, Université de Reims Champagne-Ardenne and Institut National de la Santé et de la Recherche Médicale UMR-S 903, Reims, France.
Christine
C
Clavel
Unit of Cancer Epidemiology, Centre for Cancer Prevention (CPO), Torino, Italy.
Guglielmo
G
Ronco
Departments of Laboratory Medicine, Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Joakim
J
Dillner
University of Tampere, School of Health Sciences, Tampere, Finland.
Matti
M
Lehtinen
Department of Obstetrics and Gynaecology, Klinikum Wolfsburg, Wolfsburg, Germany.
Karl-Ulrich
KU
Petry
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Mario
M
Poljak
Virus, Lifestyle &Genes, Danish Cancer Society Research Centre; and Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Susanne K
SK
Kjaer
Department of Pathology, VU University Medical Centre (VUmc), Amsterdam, Netherlands.
Chris J L M
CJ
Meijer
Department of Microbiology and Infectious Diseases, The Royal Women's Hospital; Murdoch Childrens Research Institute; and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
Suzanne M
SM
Garland
Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Jorge
J
Salmerón
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d' Oncologia-Catalan Institute of Oncology, IDIBELL, Avenida Gran Via 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Xavier
X
Castellsagué
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d' Oncologia-Catalan Institute of Oncology, IDIBELL, Avenida Gran Via 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
Laia
L
Bruni
Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d' Oncologia-Catalan Institute of Oncology, IDIBELL, Avenida Gran Via 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Silvia
S
de Sanjosé
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
Jack
J
Cuzick
D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D052162:Human papillomavirus 16 / Q000276:immunology; D052161:Human papillomavirus 18 / Q000276:immunology; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D014611:Vaccination / Q000379:methods* / Q000639:trends; D055815:Young Adult
D053918:Papillomavirus Vaccines