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.
Subscribe to Journal
Get full journal access for 1 year
only $4.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
de Sanjose, S. et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 11, 1048–1056 (2010).
de Sanjosé, S. et al. Worldwide human papillomavirus genotype attribution in over 2000 cases of intraepithelial and invasive lesions of the vulva. Eur. J. Cancer 49, 3450–3461 (2013).
Alemany, L. et al. Large contribution of human papillomavirus in vaginal neoplastic lesions: a worldwide study in 597 samples. Eur. J. Cancer 50, 2846–2854 (2014).
Alemany, L. et al. Human papillomavirus DNA prevalence and type distribution in anal carcinomas worldwide. Int. J. Cancer 136, 98–107 (2015).
Mork, J. et al. Human papillomavirus infection as a risk factor for squamous-cell carcinoma of the head and neck. N. Engl. J. Med. 344, 1125–1131 (2001).
Forman, D. et al. Global burden of human papillomavirus and related diseases. Vaccine 30 (Suppl. 5), F12–F23 (2012).
National Institutes of Health, National Cancer Institute. HPV and Cancer [online], (2015).
Cornall, A. M. et al. Anal and perianal squamous carcinomas and high-grade intraepithelial lesions exclusively associated with “low-risk” HPV genotypes 6 and 11. Int. J. Cancer 133, 2253–2258 (2013).
Ferlay, J. et al. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. WHO International Agency for Research on Cancer [online], (2010).
Parkin, D. M. & Bray, F. Chapter 2: The burden of HPV-related cancers. Vaccine 24 (Suppl. 3), 11–25 (2006).
Ferlay, J. et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. WHO International Agency for Research on Cancer [online], (2013).
American Cancer Society. Cancer Facts and Figures 2015 [online], (2015).
Vaccarella, S., Lortet-Tieulent, J., Plummer, M., Franceschi, S. & Bray, F. Worldwide trends in cervical cancer incidence: impact of screening against changes in disease risk factors. Eur. J. Cancer 49, 3262–3273 (2013).
Vaccarella, S. et al. 50 years of screening in the Nordic countries: quantifying the effects on cervical cancer incidence. Br. J. Cancer 111, 965–969 (2014).
WHO International Agency for Research on Cancer. IARC Handbooks of Cancer Prevention Volume 10: Cervix Cancer Screening 10, (IARC Press, 2005).
Salo, H. et al. The burden and costs of prevention and management of genital disease caused by HPV in women: a population-based registry study in Finland. Int. J. Cancer 133, 1459–1469 (2013).
Salo, H. et al. Divergent coverage, frequency and costs of organised and opportunistic Pap testing in Finland. Int. J. Cancer 135, 204–213 (2014).
Habbema, D., De Kok, I. M. & Brown, M. L. Cervical cancer screening in the United States and the Netherlands: a tale of two countries. Milbank Q. 90, 5–37 (2012).
Arbyn, M. et al. Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis. BMJ 337, a1284 (2008).
Cuzick, J. et al. New technologies and procedures for cervical cancer screening. Vaccine 30 (Suppl. 5), F107–F116 (2012).
Arbyn, M. et al. Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine 30 (Suppl. 5), F88–F99 (2012).
Arbyn, M. et al. Cervical cancer screening program and human papillomavirus (HPV) testing, part II: update on HPV primary screening. (Belgian Health Care Knowledge Centre [KCE], 2015).
Steben, M. et al. Upgrading public health programs for human papillomavirus prevention and control is possible in low- and middle-income countries. Vaccine 30 (Suppl. 5), F183–F191 (2012).
Meijer, C. J. et al. in The Epidemiology of Cervical Cancer and Human Papillomavirus (eds Muñoz, N., Bosch, F. X., Shah, K. V. & Meheus, A.) 271–281 (International Agency for Research on Cancer, 1992).
Cuzick, J. et al. Human papillomavirus testing in primary cervical screening. Lancet 345, 1533–1536 (1995).
Ronco, G. et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet 383, 524–532 (2014).
Cuzick, J. et al. Long-term follow-up of cervical abnormalities among women screened by HPV testing and cytology—results from the Hammersmith study. Int. J. Cancer 122, 2294–2300 (2008).
Naucler, P. et al. Human papillomavirus and Papanicolaou tests to screen for cervical cancer. N. Engl. J. Med. 357, 1589–1597 (2007).
Rijkaart, D. C. et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol. 13, 78–88 (2012).
Kitchener, H. C. et al. HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol. 10, 672–682 (2009).
Ronco, G. et al. Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol. 11, 249–257 (2010).
Wright, T. C. et al. Interlaboratory variation in the performance of liquid-based cytology: insights from the ATHENA trial. Int. J. Cancer 134, 1835–1843 (2014).
Franco, E. L., Mahmud, S. M., Tota, J., Ferenczy, A. & Coutlée, F. The expected impact of HPV vaccination on the accuracy of cervical cancer screening: the need for a paradigm change. Arch. Med. Res. 40, 478–485 (2009).
Dijkstra, M. G. et al. Cervical cancer screening: on the way to a shift from cytology to full molecular screening. Ann. Oncol. 25, 927–935 (2014).
Arbyn, M. et al. Which high-risk HPV assays fulfil criteria for use in primary cervical cancer screening? Clin. Microbiol. Infect. http://dx.doi.org/10.1016/j.cmi.2015.04.015 (2015).
Health Council of the Netherlands. Population screening for cervical cancer [online], (2011).
Ronco, G. et al. Health technology assessment report: HPV DNA based primary screening for cervical cancer precursors [Italian]. Epidemiol. Prev. 36, e1–e72 (2012).
Torné Bladé, A. et al. Guía de cribado del cáncer de cuello de útero en España, 2014. Prog. Obstet. Ginecol. 57 (Suppl. 1), 1–53 (2014).
Huh, W. K. et al. Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance. Obstet. Gynecol. 125, 330–337 (2015).
von Karsa, L. et al. European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination. Papillomavirus Res. http://dx.doi.org/10.1016/j.pvr.2015.06.006 (2015).
US Food and Drug Administration. FDA News Release: FDA approves first human papillomavirus test for primary cervical cancer screening [online], (2014).
Leinonen, M. et al. Age-specific evaluation of primary human papillomavirus screening vs conventional cytology in a randomized setting. J. Natl Cancer Inst. 101, 1612–1623 (2009).
Carozzi, F. et al. Use of p16-INK4A overexpression to increase the specificity of human papillomavirus testing: a nested substudy of the NTCC randomised controlled trial. Lancet Oncol. 9, 937–945 (2008).
Petry, K. U. et al. Triaging Pap cytology negative, HPV positive cervical cancer screening results with p16/Ki-67 dual-stained cytology. Gynecol. Oncol. 121, 505–509 (2011).
Uijterwaal, M. H. et al. Triaging HPV-positive women with normal cytology by p16/Ki-67 dual-stained cytology testing: baseline and longitudinal data. Int. J. Cancer 136, 2361–2368 (2015).
Schiffman, M. et al. A study of genotyping for management of human papillomavirus-positive, cytology-negative cervical screening results. J. Clin. Microbiol. 53, 52–59 (2015).
Verhoef, V. M. et al. Triage by methylation-marker testing versus cytology in women who test HPV-positive on self-collected cervicovaginal specimens (PROHTECT-3): a randomised controlled non-inferiority trial. Lancet Oncol. 15, 315–322 (2014).
Cuzick, J., Mayrand, M. H., Ronco, G., Snijders, P. & Wardle, J. Chapter 10: New dimensions in cervical cancer screening. Vaccine 24 (Suppl. 3), 90–97 (2006).
Cuzick, J. et al. Individual detection of 14 high risk human papilloma virus genotypes by the PapType test for the prediction of high grade cervical lesions. J. Clin. Virol. 60, 44–49 (2014).
Denny, L. et al. Screen-and-treat approaches for cervical cancer prevention in low-resource settings: a randomized controlled trial. JAMA 294, 2173–2181 (2005).
Sankaranarayanan, R. et al. HPV screening for cervical cancer in rural India. N. Engl. J. Med. 360, 1385–1394 (2009).
Kyrgiou, M. et al. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet 367, 489–498 (2006).
McCaffery, K., Waller, J., Nazroo, J. & Wardle, J. Social and psychological impact of HPV testing in cervical screening: a qualitative study. Sex. Transm. Infect. 82, 169–174 (2006).
Kwan, T. T. et al. Psychological burden of testing positive for high-risk human papillomavirus on women with atypical cervical cytology: a prospective study. Acta Obstet. Gynecol. Scand. 90, 445–451 (2011).
Hendry, M. et al. Are women ready for the new cervical screening protocol in England? A systematic review and qualitative synthesis of views about human papillomavirus testing. Br. J. Cancer 107, 243–254 (2012).
Qiao, Y.-L. et al. Lower cost strategies for triage of human papillomavirus DNA-positive women. Int. J. Cancer 134, 2891–2901 (2014).
Chen, W. et al. The concordance of HPV DNA detection by Hybrid Capture 2 and care HPV on clinician- and self-collected specimens. J. Clin. Virol. 61, 553–557 (2014).
Arbyn, M. et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol. 15, 172–183 (2014).
Pathak, N., Dodds, J., Zamora, J. & Khan, K. Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis. BMJ 349, g5264 (2014).
Castle, P. E. et al. Reliability of the Xpert HPV assay to detect high-risk human papillomavirus DNA in a colposcopy referral population. Am. J. Clin. Pathol. 143, 126–133 (2015).
Schiller, J. T., Castellsagué, X. & Garland, S. M. A review of clinical trials of human papillomavirus prophylactic vaccines. Vaccine 30 (Suppl. 5), F123–F138 (2012).
Lehtinen, M. & Dillner, J. Clinical trials of human papillomavirus vaccines and beyond. Nat. Rev. Clin. Oncol. 10, 400–410 (2013).
Stillo, M., Carrillo Santisteve, P. & Lopalco, P. L. Safety of human papillomavirus vaccines: a review. Expert Opin. Drug Saf. 14, 697–712 (2015).
US Food and Drug Administration. June 8, 2006 Approval Letter: Human Papillomavirus Quadrivalent (Types 6, 11, 16, 18) Vaccine, Recombinant [online], (2006).
Herrero, R. et al. Reduced prevalence of oral human papillomavirus (HPV) 4 years after bivalent HPV vaccination in a randomized clinical trial in Costa Rica. PLoS ONE 8, e68329 (2013).
Garland, S. M. The Australian experience with the human papillomavirus vaccine. Clin. Ther. 36, 17–23 (2014).
Hariri, S. et al. Reduction in HPV 16/18-associated high grade cervical lesions following HPV vaccine introduction in the United States—2008–2012. Vaccine 33, 1608–1613 (2015).
Baldur-Felskov, B., Dehlendorff, C., Munk, C. & Kjaer, S. K. Early impact of human papillomavirus vaccination on cervical neoplasia--nationwide follow-up of young Danish women. J. Natl Cancer Inst. 106, djt460 (2014).
Joura, E. A. et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N. Engl. J. Med. 372, 711–723 (2015).
Drolet, M. et al. Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect. Dis. 15, 565–580 (2015).
Tabrizi, S. N. et al. Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross-sectional study. Lancet Infect. Dis. 14, 958–966 (2014).
Guan, P. et al. Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer. Int. J. Cancer 131, 2349–2359 (2012).
US Food and Drug Administration. FDA News Release: FDA approves Gardasil 9 for prevention of certain cancers caused by five additional types of HPV [online], (2014).
European Medicines Agency. Gardasil 9 [online], (2015).
Lehtinen, M. et al. Overall efficacy of HPV-16/18 AS04-adjuvanted vaccine against grade 3 or greater cervical intraepithelial neoplasia: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial. Lancet Oncol. 13, 89–99 (2012).
Mesher, D. et al. Reduction in HPV 16/18 prevalence in sexually active young women following the introduction of HPV immunisation in England. Vaccine 32, 26–32 (2013).
Malagón, T. et al. Cross-protective efficacy of two human papillomavirus vaccines: a systematic review and meta-analysis. Medicine (Baltimore) 94, e722 (2015).
David, M.-P. et al. Long-term persistence of anti-HPV-16 and -18 antibodies induced by vaccination with the AS04-adjuvanted cervical cancer vaccine: modeling of sustained antibody responses. Gynecol. Oncol. 115, S1–S6 (2009).
Aregay, M., Shkedy, Z., Molenberghs, G., David, M.-P. & Tibaldi, F. Model-based estimates of long-term persistence of induced HPV antibodies: a flexible subject-specific approach. J. Biopharm. Stat. 23, 1228–1248 (2013).
Markowitz, L. E. et al. Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm. Rep. 56, 1–24 (2007).
Giuliano, A. R. et al. Efficacy of quadrivalent HPV vaccine against HPV Infection and disease in males. N. Engl. J. Med. 364, 401–411 (2011).
Palefsky, J. M. et al. HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N. Engl. J. Med. 365, 1576–1585 (2011).
Castellsagué, X. et al. End-of-study safety, immunogenicity, and efficacy of quadrivalent HPV (types 6, 11, 16, 18) recombinant vaccine in adult women 24–45 years of age. Br. J. Cancer 105, 28–37 (2011).
Skinner, S. R. et al. Efficacy, safety, and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 4-year interim follow-up of the phase 3, double-blind, randomised controlled VIVIANE study. Lancet 384, 2213–2227 (2014).
Kim, J. J., Brisson, M., Edmunds, W. J. & Goldie, S. J. Modeling cervical cancer prevention in developed countries. Vaccine 26 (Suppl. 10), K76–K86 (2008).
Markowitz, L. E. et al. Human papillomavirus vaccine introduction--the first five years. Vaccine 30 (Suppl. 5), F139–F148 (2012).
Elfström, K. M., Dillner, J. & Arnheim-Dahlström, L. Organization and quality of HPV vaccination programs in Europe. Vaccine 33, 1673–1681 (2015).
Franco, E. L., Cuzick, J., Hildesheim, A. & de Sanjosé, S. Chapter 20: Issues in planning cervical cancer screening in the era of HPV vaccination. Vaccine 24 (Suppl. 3), 171–177 (2006).
Tota, J. E., Ramana-Kumar, A. V., El-Khatib, Z. & Franco, E. L. The road ahead for cervical cancer prevention and control. Curr. Oncol. 21, e255–e264 (2014).
Kjaer, S. K., Frederiksen, K., Munk, C. & Iftner, T. Long-term absolute risk of cervical intraepithelial neoplasia grade 3 or worse following human papillomavirus infection: role of persistence. J. Natl Cancer Inst. 102, 1478–1488 (2010).
de Sanjose, S. et al. Age-specific occurrence of HPV16- and HPV18-related cervical cancer. Cancer Epidemiol. Biomarkers Prev. 22, 1313–1318 (2013).
GAVI: The Vaccine Alliance. Human papillomavirus vaccine support [online], (2015).
[No authors listed] Human papillomavirus vaccines: WHO position paper, October 2014. Wkly Epidemiol. Rec. 89, 465–491 (2014).
Hildesheim, A. et al. Effect of human papillomavirus 16/18 L1 viruslike particle vaccine among young women with preexisting infection: a randomized trial. JAMA 298, 743–753 (2007).
Gertig, D. M. et al. Impact of a population-based HPV vaccination program on cervical abnormalities: a data linkage study. BMC Med. 11, 227 (2013).
Lehtinen, M. et al. Characteristics of a cluster-randomized phase IV human papillomavirus vaccination effectiveness trial. Vaccine 33, 1284–1290 (2015).
Edgren, G. & Sparén, P. Risk of anogenital cancer after diagnosis of cervical intraepithelial neoplasia: a prospective population-based study. Lancet Oncol. 8, 311–316 (2007).
Kang, W. D., Choi, H. S. & Kim, S. M. Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN2–3)? Gynecol. Oncol. 130, 264–268 (2013).
Australian Government. Medical Services Advisory Committee, Standing Committee on Screening. MSAC Outcomes: Application no. 1276—renewal of the National Cervical Screening Program [online], (2014).
Rodríguez, A. C. et al. Longitudinal study of human papillomavirus persistence and cervical intraepithelial neoplasia grade 2/3: critical role of duration of infection. J. Natl Cancer Inst. 102, 315–324 (2010).
Castañón, A., Landy, R., Cuzick, J. & Sasieni, P. Cervical screening at age 50–64 years and the risk of cervical cancer at age 65 years and older: population-based case control study. PLoS Med. 11, e1001585 (2014).
Gravitt, P. E. The known unknowns of HPV natural history. J. Clin. Invest. 121, 4593–4599 (2011).
Gravitt, P. E. Evidence and impact of human papillomavirus latency. Open Virol. J. 6, 198–203 (2012).
Trottier, H. et al. Human papillomavirus infection and reinfection in adult women: the role of sexual activity and natural immunity. Cancer Res. 70, 8569–8577 (2010).
Veldhuijzen, N. J., Snijders, P. J., Reiss, P., Meijer, C. J. & van de Wijgert, J. H. Factors affecting transmission of mucosal human papillomavirus. Lancet Infect. Dis. 10, 862–874 (2010).
Safaeian, M. et al. Epidemiological study of anti-HPV16/18 seropositivity and subsequent risk of HPV16 and -18 infections. J. Natl Cancer Inst. 102, 1653–1662 (2010).
Castellsagué, X. et al. Risk of newly detected infections and cervical abnormalities in women seropositive for naturally acquired human papillomavirus type 16/18 antibodies: analysis of the control arm of PATRICIA. J. Infect. Dis. 210, 517–534 (2014).
Dempsey, A. F., Brewer, S. E., Pyrzanowski, J., Sevick, C. & O'leary, S. T. Acceptability of human papillomavirus vaccines among women older than 26 years. Vaccine 33, 1556–1561 (2015).
Marshall, H., Ryan, P., Roberton, D. & Baghurst, P. A cross-sectional survey to assess community attitudes to introduction of human papillomavirus vaccine. Aust. N. Z. J. Public Health 31, 235–242 (2007).
Cui, Y., Baldwin, S. B., Wiley, D. J. & Fielding, J. E. Human papillomavirus vaccine among adult women: disparities in awareness and acceptance. Am. J. Prev. Med. 39, 559–563 (2010).
Agorastos, T. et al. Distinct demographic factors influence the acceptance of vaccination against HPV. Arch. Gynecol. Obstet. 292, 197–205 (2015).
Anhang Price, R., Koshiol, J., Kobrin, S. & Tiro, J. A. Knowledge and intention to participate in cervical cancer screening after the human papillomavirus vaccine. Vaccine 29, 4238–4243 (2011).
Lazcano-Ponce, E., Alonso, P., Ruiz-Moreno, J. A. & Hernández-Avila, M. Recommendations for cervical cancer screening programs in developing countries. The need for equity and technological development. Salud Pública México 45 (Suppl. 3), S449–S462 (2003).
Almonte, M. et al. New paradigms and challenges in cervical cancer prevention and control in Latin America [Spanish]. Salud Pública México 52, 544–559 (2010).
Poljak, M. et al. Recommendations for cervical cancer prevention in Central and Eastern Europe and Central Asia. Vaccine 31 (Suppl. 7), H80–H82 (2013).
Dasbach, E. J., Largeron, N. & Elbasha, E. H. Assessment of the cost-effectiveness of a quadrivalent HPV vaccine in Norway using a dynamic transmission model. Expert Rev. Pharmacoecon. Outcomes Res. 8, 491–500 (2008).
Kim, J. J. & Goldie, S. J. Health and economic implications of HPV vaccination in the United States. N. Engl. J. Med. 359, 821–832 (2008).
Usher, C. et al. Cost-effectiveness of human papillomavirus vaccine in reducing the risk of cervical cancer in Ireland due to HPV types 16 and 18 using a transmission dynamic model. Vaccine 26, 5654–5661 (2008).
Dasbach, E. J., Insinga, R. P. & Elbasha, E. H. The epidemiological and economic impact of a quadrivalent human papillomavirus vaccine (6/11/16/18) in the UK. BJOG 115, 947–956 (2008).
Jit, M., Choi, Y. H. & Edmunds, W. J. Economic evaluation of human papillomavirus vaccination in the United Kingdom. BMJ 337, a769 (2008).
Kim, J. J., Ortendahl, J. & Goldie, S. J. Cost-effectiveness of human papillomavirus vaccination and cervical cancer screening in women older than 30 years in the United States. Ann. Intern. Med. 151, 538–545 (2009).
Elbasha, E. H., Dasbach, E. J., Insinga, R. P., Haupt, R. M. & Barr, E. Age-based programs for vaccination against HPV. Value Health 12, 697–707 (2009).
Dasbach, E. J., Nagy, L., Brandtmüller, A. & Elbasha, E. H. The cost effectiveness of a quadrivalent human papillomavirus vaccine (6/11/16/18) in Hungary. J. Med. Econ. 13, 110–118 (2010).
Olsen, J. & Jepsen, M. R. Human papillomavirus transmission and cost-effectiveness of introducing quadrivalent HPV vaccination in Denmark. Int. J. Technol. Assess. Health Care 26, 183–191 (2010).
Westra, T. A. et al. Until which age should women be vaccinated against HPV infection? Recommendation based on cost-effectiveness analyses. J. Infect. Dis. 204, 377–384 (2011).
Demarteau, N., Detournay, B., Tehard, B., El Hasnaoui, A. & Standaert, B. A generally applicable cost-effectiveness model for the evaluation of vaccines against cervical cancer. Int. J. Public Health 56, 153–162 (2011).
Bogaards, J. A., Coupé, V. M. H., Meijer, C. J. L. M. & Berkhof, J. The clinical benefit andcost-effectiveness of human papillomavirus vaccination for adult women in the Netherlands. Vaccine 29, 8929–8936 (2011).
Demarteau, N., Van Kriekinge, G. & Simon, P. Incremental cost-effectiveness evaluation of vaccinating girls against cervical cancer pre- and post-sexual debut in Belgium. Vaccine 31, 3962–3971 (2013).
Turner, H. C., Baussano, I. & Garnett, G. P. Vaccinating women previously exposed to human papillomavirus: a cost-effectiveness analysis of the bivalent vaccine. PLoS ONE 8, e75552 (2013).
Baussano, I., Lazzarato, F., Ronco, G., Dillner, J. & Franceschi, S. Benefits of catch-up in vaccination against human papillomavirus in medium- and low-income countries. Int. J. Cancer 133, 1876–1881 (2013).
Baussano, I., Dillner, J., Lazzarato, F., Ronco, G. & Franceschi, S. Upscaling human papillomavirus vaccination in high-income countries: impact assessment based on transmission model. Infect. Agent. Cancer 9, 4 (2014).
Burger, E. A., Sy, S., Nygård, M., Kristiansen, I. S. & Kim, J. J. Prevention of HPV-related cancers in Norway: cost-effectiveness of expanding the HPV vaccination program to include pre-adolescent boys. PLoS ONE 9, e89974 (2014).
Jit, M., Brisson, M., Laprise, J.-F. & Choi, Y. H. Comparison of two dose and three dose human papillomavirus vaccine schedules: cost effectiveness analysis based on transmission model. BMJ 350, g7584 (2015).
Cervical cancer prevention. Cervical cancer prevention in Europe: CoheaHr [online], (2015).
Lazcano-Ponce, E. et al. Specimen self-collection and HPV DNA screening in a pilot study of 100,242 women. Int. J. Cancer 135, 109–116 (2014).
US National Library of Medicine. ClinicalTrials.gov [online], (2015).
HPV 2015. 30th International Papillomavirus Conference, September 17–21, 2015, Lisbon, Portugal [online], (2015).
Bruni, L. et al. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J. Infect. Dis. 202, 1789–1799 (2010).
Kyrgiou, M. et al. The up-to-date evidence on colposcopy practice and treatment of cervical intraepithelial neoplasia: the Cochrane colposcopy & cervical cytopathology collaborative group (C5 group) approach. Cancer Treat. Rev. 32, 516–523 (2006).
McCredie, M. R. et al. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. Lancet Oncol. 9, 425–434 (2008).
Muñoz, N. et al. Safety, immunogenicity, and efficacy of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in women aged 24–45 years: a randomised, double-blind trial. Lancet 373, 1949–1957 (2009).
The authors are grateful for the work of all the collaborators and personnel involved in the HPV European Consortium. The work of the authors was partially supported by the European Union Seventh Framework Programme (grant agreement #603019; CoheaHr) to all authors except S.M.G. and J.S.; the Spanish Ministry of Economy and Competitiveness via the Instituto de Salud Carlos III (RD12/0036/0056 and CIBERESP) to F.X.B., C.R., M.D., X.C., L.B. and S.d.S.; the Government of Catalonia via the Agència de Gestió d'Ajuts Universitaris i de Recerca (Agency for Management of University and Research Grant 2014SGR1077 and 2014SGR2016 to F.X.B., C.R., M.D., X.C., L.B. and S.d.S.); the Lilly Foundation (Premio de Investigación Biomédica Preclínica 2012 to F.X.B.); the National Institute of Public Health and the Environment (Bilthoven, Netherlands) to M.A.; the German Guideline Program in Oncology (German Cancer Aid project #110163 to M.A.); the Belgian Health Care Knowledge Centre (Brussels, Belgium) to M.A.; the Bill and Melinda Gates Foundation (OPP1053353 to I.B.); the Institut National du Cancer to C.C.; Zorgonderzoek Nederland-Medische Wetenschappen (ZON-MW) and the Dutch Cancer Society to C.J.L.M.M.; and Cancer Research UK (C569/A16891 to J.C.).
F.X.B., C.R., M.D., X.C., L.B. and S.d.S. have received research funding via their institution from Genticel, GlaxoSmithKline, Merck, Qiagen, Roche, and Sanofi Pasteur MSD. F.X.B. has received reimbursement of travel expenses for attending symposia, meeting and/or conferences from GlaxoSmithKline, Merck, Qiagen, Roche, and Sanofi Pasteur MSD. C.C. has received reimbursement of travel expenses for attending symposia, meeting and/or conferences from Hologic, Roche, and Sanofi Pasteur MSD; and honoraria as a scientific advisory board member from Roche and Sanofi Pasteur MSD. J.D. has received research funding via his institution from Merck and Sanofi Pasteur MSD. K.-U.P. has received research funding via his institution from Sanofi Pasteur MSD; has been an consultant for Becton Dickinson, Roche Diagnostics, and Sanofi Pasteur MSD; and has receiving speakers' honoraria from Becton Dickinson, GlaxoSmithKline, and Roche. M.P. has received reimbursement of travel expenses for attending symposia, meeting and/or conferences, and honoraria for speaking and consultancy from Abbott. S.K.K. has received research funding via her institution, and honorarium as a scientific advisory board member and speaker from Merck and Sanofi Pasteur MSD. C.J.L.M.M. has received research funding from Abbott and Gen-Probe; has minority stock of Diassay and Self-Screen, a spin-off company of the Vrije Universiteit Medical Centre; has held shares in Delphi Biosciences, a former producer of a lavage self-sampling device for cervical cancer screening until 2014, when it went into receivership; has received honoraria from Genticel and Qiagen; has received honoraria occasionally as a scientific advisory board member or for serving at the speakers bureau of GlaxoSmithKline, Qiagen, Roche, and Sanofi Pasteur MSD/Merck; has received honoraria as speaker from Menarini and Seegene; and has received research funding via his institution from GlaxoSmithKline and Sanofi Pasteur MSD. S.M.G. has received research funding via her institution from CSL Bio, GlaxoSmithKline, and Merck; and is a member of the Merck Global Advisory Board and the Merck Scientific Advisory Committee for HPV (unpaid position). X.C. has received reimbursement of travel expenses for attending symposia, meeting and/or conferences from Genticel, GlaxoSmithKline, Merck, Sanofi Pasteur MSD, and Vianex. S.d.S. has received reimbursement of travel expenses for attending symposia, meeting and/or conferences from GlaxoSmithKline, Qiagen, and Sanofi Pasteur MSD. J.C. has received research funding via his institution from Abbott, Beckton Dickinson, Cepheid, Genera, Hologic, Qiagen, and Trovagene; honoraria from Hologic Cepheid, and Merck; and has been on sponsored speakers bureau for Trovagene. M.A., I.B., G.R., M.L. and J.S. declare no competing interests.
About this article
Cite this article
Bosch, F., Robles, C., Díaz, M. et al. HPV-FASTER: broadening the scope for prevention of HPV-related cancer. Nat Rev Clin Oncol 13, 119–132 (2016). https://doi.org/10.1038/nrclinonc.2015.146
Elimination of cervical cancer in low‐ and middle‐income countries: Inequality of access and fragile healthcare systems
International Journal of Gynecology & Obstetrics (2021)
High Prevalence of Cervical High-Risk Human Papillomavirus Harboring Atypical Genotypes in Human Immunodeficiency Virus -Infected and -Uninfected First-Generation Adult Immigrant Women Originating from Sub-Saharan Africa and Living in France
Journal of Immigrant and Minority Health (2021)
JNCI: Journal of the National Cancer Institute (2021)
Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
CA: A Cancer Journal for Clinicians (2021)
Efficacy of the AS04-adjuvanted HPV-16/18 vaccine in young Chinese women with oncogenic HPV infection at baseline: post-hoc analysis of a randomized controlled trial
Human Vaccines & Immunotherapeutics (2021)