Cervical cancer screening in women vaccinated against human papillomavirus infection: Recommendations from a consensus conference

PREVENTIVE MEDICINE

卷:98

Article

Rossi, Paolo Giorgi^1,2  Carozzi, Francesca³  Federici, Antonio⁴  Ronco, Guglielmo⁵  Zappa, Marco⁶  Franceschi, Silvia⁷ 

[1] Azienda Unita Sanit Locale, Epidemiol Unit, Via Amendola 2, I-42122 Reggio Emilia, Italy

[2] IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy

[3] ISPO, Canc Prevent & Res Inst, Canc Prevent Reg Lab, Via Cosimo Vecchio 2, I-50139 Florence, Italy

[4] Italian Minist Hlth, Rome, Italy

[5] AO City Hlth & Sci, Ctr Canc Epidemiol & Prevent, Turin, Italy

[6] ISPO, Unit Clin & Descript Epidemiol, Florence, Italy

[7] Int Agcy Res Canc, F-69372 Lyon 08, France

关键词: Uterine Cervical Neoplasms;    Human Papillomavirus DNA Test;    Mass screening;    Papillomavirus Vaccines;    Women's Health Services;    Primary Prevention;    Secondary Prevention;   

DOI  :  10.1016/j.ypmed.2016.11.020

来源: Elsevier

【 摘 要 】

In Italy, the cohorts of women who were offered Human papillomavirus (HPV) vaccination in 2007/08 will reach the age (25 years) 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 5 years, 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. (C) 2016 The Authors. Published by Elsevier Inc.

【 授权许可】

Free