A concern with widespread implementation of HPV vaccination programs is that women may mistakenly decide that they do not need to be screened any longer, and thus be less likely to participate in cervical cancer screening, because they view themselves to be at low-risk of developing cervical cancer. We hypothesized that non-participation in screening among vaccinated young women in the 5 years following vaccination may result in missed CIN 2-3 cases that could progress to cancer. For instance, if 50% fewer women 26-30 years old, who were vaccinated, participate in screening in the United States over a 5 year time horizon, there would be approximately 4 women (per 1000) with missed CIN 2-3. On the other hand, non-participation will reduce the number of false-positive screening test results, as non-participation would avoid approximately 27 false-positive test results, with a decrease in follow-up procedures and costs. These results highlight the importance of educating women to ensure continued screening, as well as the need to consider new approaches to screening in the era of vaccination.
Bibliographical noteFunding Information:
The views expressed in this paper are those of the authors only and do not reflect the views, positions or policy of the organizations they are affiliated with. Dr. Kulasingam is currently supported by an NIH career development award (NIH 1K07 CA113773). She has previously been supported by unrestricted grants and/or been a consultant for Merck, CSL and Sanofi Pasteur MSD. Dr. Myers has received unrestricted grants and/or been a consultant for Merck, CSL-Australia and Sanofi Pasteur MSD. Dr. Pagliusi is a former employee of Digene Switzerland.
- Cervical cancer screening
- Human papillomavirus