title: Cervical cancer screening in women vaccinated against human papillomavirus infection: Recommendations from a consensus conference.
abstract: In Italy, the cohorts of women who were offered Human papillomavirus (HPV) vaccination in 2007/08 will reach the age (25years) for cervical cancer (CC) screening from 2017. The simultaneous shift from cytology-based screening to HPV test-based screening gives the opportunity for unprecedented reorganisation of CC prevention. The ONS (National Screening Monitoring Centre) Directive and the GISCi (Italian Group for Cervical Screening) identified the consensus conference as the most suitable method for addressing this topic. A summary of consensus recommendations is reported here. The main objective was to define the best screening methods in girls vaccinated against HPV and the knowledge required for defining evidence-based screening strategies. A Jury made recommendations about questions and proposals formulated by a panel of experts representative of Italian scientific societies involved in CC prevention and based on systematic reviews of literature and evidence. The Jury considered changing the screening protocols for girls vaccinated in their twelfth year as appropriate. Tailored screening protocols based on vaccination status could be replaced by "one size fits all" protocols only when a herd immunity effect has been reached. Vaccinated women should start screening at age 30, instead of 25, with HPV test. Furthermore, there is a strong rationale for applying longer intervals for re-screening HPV negative women than the currently recommended 5years, but research is needed to determine the optimal screening time points. For non-vaccinated women and for women vaccinated in their fifteenth year or later, the current protocol should be kept.
authors.affiliation: Epidemiology Unit, Azienda Unità Sanitaria Locale, Via Amendola 2, 42122, Reggio Emilia, Italy; Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico - IRCCS, Reggio Emilia, Italy. Electronic address: paolo.giorgirossi@ausl.re.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.affiliation: Cancer Prevention Regional Laboratory, ISPO, Cancer Prevention and Research Institute, Florence, Italy. Electronic address: f.carozzi@ispo.toscana.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Carozzi
authors.affiliation: Italian Ministry of Health, Rome, Italy. Electronic address: an.federici@sanita.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Federici
authors.affiliation: Center for Cancer Epidemiology and Prevention, AO City of Health and Science, Turin, Italy. Electronic address: guglielmo.ronco@cpo.it.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ronco
authors.affiliation: Unit of Clinical and Descriptive Epidemiology, ISPO, Florence, Italy. Electronic address: m.zappa@ispo.toscana.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Zappa
authors.affiliation: International Agency for Research on Cancer, 69372 Lyon Cedex 08, France. Electronic address: franceschis@iarc.fr.
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007558:Italy; D053918:Papillomavirus Vaccines; D011322:Primary Prevention; D055502:Secondary Prevention; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014611:Vaccination; D014932:Women's Health Services
chemical_list: D053918:Papillomavirus Vaccines
keywords: Human Papillomavirus DNA Test; Mass screening; Papillomavirus Vaccines; Primary Prevention; Secondary Prevention; Uterine Cervical Neoplasms; Women's Health Services