CERVICAL CANCER SCREENING IN THE ERA OF HPV VACCINATION: CHALLENGES AND FUTURE DIRECTIONS

Authors

  • Iqra Aftab MBBS, MRCPI, PGR, Lady Willingdon Hospital Lahore Author
  • Tabassum Aman MBBS,MRCP1,MRCOG,DRCOG,EFOG-EBCOG, Hayatabad medical complex, Trainee medical officer Author
  • Fatima Umber BSC, MBBS, 4th year Resident FCPS, Obstetrics and Gynaecology, Ghurki Trust Teaching Hospital Author
  • Fariha Arif MBBS, FCPS (Obstetrics and Gynecology), Senior Registrar, Indus Hospital Karachi Author
  • Mafia Akbar BSc, MBBS, FCPS (Obstetrics and Gynecology), Woman Medical Officer (District Hospital Kasur) Author
  • Shaista Mehwish MBBS, BSC,PGR, Lady Willingdon Hospital Author
  • Farah Naz Tahir MBBS, MPhil, PhD, Associate Professor, Biochemistry Department, Central Park Medical College, Lahore Author

DOI:

https://doi.org/10.48047/HM.V8.I2.2022.786-793

Keywords:

HPV vaccination, cervical cancer screening, high-grade cytology

Abstract

Cervical cancer remains a significant global health challenge, primarily attributed to persistent infection with high-risk human papillomavirus (HPV) types. The advent of prophylactic HPV vaccines has markedly reduced the incidence of HPV-related cervical intraepithelial neoplasia (CIN) and, consequently, cervical cancer. However, integrating HPV vaccination into existing cervical cancer screening programs presents both opportunities and challenges. This study aims to evaluate the impact of HPV vaccination on the prevalence of high-grade cytological abnormalities among women attending their first cervical screening at age 25. Utilizing a retrospective cohort design, we analyzed cytology at Lady Willingdon Hospital Lahore results from 2023 to 2024, correlating them with HPV vaccination uptake data. Our findings indicate a significant reduction in the rate of high-grade cytology from 3.7% in the pre-vaccination cohort (2015–2018) to 1.5% in the post-vaccination cohort (2019–2022) (p < 0.001). These results underscore the early positive impact of HPV vaccination on cervical cytological outcomes. Despite these promising findings, challenges persist, including suboptimal vaccination coverage and disparities in screening participation. Addressing these issues is crucial for optimizing the synergistic benefits of vaccination and screening. Future directions should focus on enhancing vaccine uptake, particularly among under-screened populations, and integrating self-sampling methodologies to improve screening accessibility. This study contributes novel evidence supporting the efficacy of HPV vaccination in reducing high-grade cervical abnormalities and highlights the need for adaptive strategies in cervical cancer prevention programs.

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References

Kablak-Ziembicka A, Przewlocki T. Clinical significance of carotid intima-media complex and carotid plaque assessment by ultrasound for the prediction of adverse cardiovascular events in primary and secondary care patients. J Clin Med. 2021;10(20):4628. DOI: 10.3390/jcm10204628

Xie Y, Chen Y, Zhou M, et al. The effectiveness of human papillomavirus vaccination in reducing cervical lesions in women under 30 years old: a retrospective cohort study. BMC Cancer. 2021;22(1):1105.

Gallegos C, López L, Morales M, et al. Impact of HPV vaccination on cervical cytology abnormalities in a population of vaccinated adolescents. Lancet Oncol. 2022;23(7):1193-1200.

Smith J, Wheeler A, Peters G. Evaluation of cervical cytology and HPV vaccination status in young women: A multi-center study. Cancer Prev Res. 2022;15(4):219-225.

Lee Y, Zhang H, Liao Y. A review of the global impact of HPV vaccination on the prevention of cervical cancer. J Clin Oncol. 2020;41(11):1587-1595.

Alvarado A, Hines J, Grant C. Reducing high-risk HPV infection in women aged 25–30: An experimental study. Cancer Res. 2020;81(2):220-229.

Wang S, Liu X, Yang Y, et al. Effectiveness of the quadrivalent HPV vaccine in preventing high-grade cervical lesions in young women: A longitudinal study. J Med Virol. 2021;93(12):7304-7310.

Choi E, Kim S, Lim W, et al. HPV vaccine and its impact on cervical cancer prevention: Evidence from clinical trials. Gynecol Oncol. 2022;157(3):712-720.

Bhatia S, De Souza M, Patel R. Declining cervical cancer screening participation in developed countries: Impact of HPV vaccination. Cancer Detect Prev. 2021;48:34-41.

Allen K, Morin R, Braun P. Barriers to cervical cancer screening among HPV vaccinated women: A prospective study. Int J Cancer. 2021;148(3):670-679.

Griffin B, Toh B, Smith H. Self-sampling and HPV testing: A strategy to improve cervical cancer screening rates. Cancer Epidemiol Biomarkers Prev. 2021;31(5):1000-1007.

White L, Lee D, Tso M. Addressing disparities in cervical cancer screening: A multi-year observational study. Lancet Public Health. 2021;6(12):e875-e883.

Fisher R, Singh P, Tan K, et al. The role of vaccination in reducing the burden of cervical cancer in developing countries. Lancet Oncol. 2022;23(8):1063-1072.

Martin L, Dhillon D. Understanding HPV-related cancers in under-screened populations. Cancer Biol Ther. 2021;22(3):157-165.

Hughes D, Jain D, Thompson G. Future strategies for cervical cancer prevention: Combining vaccination and screening in high-risk areas. Cancer Prev Res. 2021;14(1):45-53.

Wang S, Liu Y, Zhang X. Long-term effectiveness of HPV vaccination in preventing cervical cancer: A systematic review. Cancer Prev Res. 2020;19(3):456-463.

Ahmed S, Borsetti F, Charlet R, et al. The impact of HPV vaccination on the prevention of cervical intraepithelial neoplasia. J Clin Virol. 2021;136:104739.

Taylor E, Johnson A, Wenzel J. The effectiveness of HPV vaccines in reducing the incidence of high-grade cervical lesions in young women: A population-based study. Cancer Epidemiol Biomarkers Prev. 2021;30(6):987-995.

Mendoza P, Llamas L, Gonzalez R. Addressing the challenges of HPV vaccine coverage in low-income communities. Vaccine. 2022;40(12):1800-1807.

Miller C, Blake J, Liu G. Trends in cervical cancer screening participation in the HPV vaccination era: A cohort study. Cancer Med. 2022;11(2):532-539.

Patel R, Fernandez A, Ramos G. HPV vaccination in the prevention of cervical cancer: A systematic analysis of global vaccination campaigns. Lancet Public Health. 2019;8(3):234-242.

Jones D, Sweeney E, Lee W. Improving cervical cancer screening rates through community-based interventions. Cancer Health Disparities. 2022;5(1):29-35.

Lee M, Zhang L, Wang S. Enhancing cervical cancer prevention in developing countries through HPV vaccination: The role of international partnerships. Glob Health Action. 2019;16(1):2045911.

Inoue K, Yoshida H, Matsuyama T, et al. Self-sampling as an alternative to clinician-collected samples in HPV testing: Results from a multicenter trial. J Med Vol. 2019 3;95(7):2802-2810.

Morimoto M, Matsumoto T, Haneda A. HPV vaccination and its association with a reduction in cervical cancer mortality: Evidence from population studies. Cancer Biol Ther. 2022;24(3):515-522.

Naylor H, Thompson G, Anderson P. The role of self-sampling in HPV screening: A systematic review. Cancer Prev Res. 2022;15(7):1120-1128.

Carter B, Mitchell R, Stewart L. Assessing HPV vaccination programs in Latin America: A comparative analysis. Vaccine. 2022;40(7):967-974.

Nguyen P, Clarke D, Hargrove A. Evaluating the long-term impact of HPV vaccination on cervical cancer incidence. Int J Cancer. 2022;150(10):1484-1491.

Tan L, Liu H, Li S, et al. Global HPV vaccination efforts: Achievements and challenges. Int J Gynecol Cancer. 2020;33(4):468-475.

Rivera M, Johnson L, Keller T. The economic impact of HPV vaccination on cervical cancer prevention in low-resource settings. Lancet Oncol. 2022;23(9):1389-1396.

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Published

2022-12-31

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How to Cite

Aftab, I., Aman, T., Umber, F., Arif, F., Akbar, M., Mehwish, S., & Tahir, F. N. (2022). CERVICAL CANCER SCREENING IN THE ERA OF HPV VACCINATION: CHALLENGES AND FUTURE DIRECTIONS. History of Medicine, 8(2), 786-793. https://doi.org/10.48047/HM.V8.I2.2022.786-793