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Cervical cancer in the human papillomavirus vaccination era

Tay, Sun-Kuie

Current Opinion in Obstetrics & Gynecology: February 2012 - Volume 24 - Issue 1 - p 3–7
doi: 10.1097/GCO.0b013e32834daed9
GYNECOLOGIC CANCER: Edited by Anne O. Rodriguez

Purpose of review: To evaluate the potential changes in the epidemiology of cervical cancer based on recently emerged information from mass vaccination programs beyond clinical trials.

Recent findings: Limited sensitivity and unequal access to screening have resulted in an imbalance in distribution of the burden of cervical cancer between developed and developing countries, between metropolitan and rural areas in developed countries, and among women from different ethnic groups. In screened populations, there is a relative increase in incidence of cervical cancer in young and elderly women, and an increased proportion of adenocarcinoma. A high coverage of the target population has been achieved in human papillomavirus (HPV) vaccination programs in many countries. After 3 years of mass vaccination of adolescent girls, surveillance data in Australia confirmed a significant reduction in high-grade abnormalities for girls aged 18 years and below.

Summary: HPV vaccination is more feasible than cytology screening for universal implementation across geographic sectors and demographic groups within individual countries and over the world. The high vaccine efficacy should significantly reduce the total burden and unequal distribution of invasive cervical cancer, including adenocarcinoma hitherto observed. These epidemiological changes provoke consideration for appropriate modifications of the current screening program.

Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore, Republic of Singapore

Correspondence to Sun-Kuie Tay, Department of Obstetrics and Gynaecology, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore. Tel: +65 6321 4377; e-mail: tay.sun.kuie@sgh.com.sg

© 2012 Lippincott Williams & Wilkins, Inc.