scholarly journals Evaluation of additional benefits of HPV vaccination to cervical cancer screening in France

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Rousseau ◽  
M Massetti ◽  
S Barre ◽  
H Leleu ◽  
J Gaillot-de Saintignon
Keyword(s):  
Cervical Cancer ◽  
Health Inequalities ◽  
Precancerous Lesions ◽  
Hpv Vaccination ◽  
Cost Effective ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Effective Measure ◽  
Underserved Women ◽  
Increased Risk

Abstract Background The National Cancer Institute (INCa) undertook the evaluation of the expected impact of HPV vaccination in the context of the recent marketing of nonavalent vaccine (Gardasil®9) and the implementation of organized screening (OS) of cervical cancer (CC) in France. Methods The study is based on a microsimulation model that replicates the natural history of CC. A cohort of 14-year-old women is generated and followed until death. Others HPV-infection related diseases (condyloma, anal cancer, penile cancer and oropharynx cancer) are not modelled. Different strategies were compared with the current vaccination coverage rate (VCR) of 21.4% (2017): impact of increased VCR alone and increased VCR combined with correction of inequalities (CI). Results are presented according to two hypotheses for the duration of protection offered by the vaccine (limited to 20 years and lifelong) and according to two hypotheses for price of the vaccine (French price and average European prices). Results The incremental cost-effectiveness ratio (ICER) was less than 15 000 euros per QALY (quality-adjusted life year) in all the assessed strategies. For each 14-year-old women cohort, 85% VCR with CI would prevent at least: 2 546 conations, 2 347 precancerous lesions CIN 2 / 3 diagnosed, 377 CCs, 139 deaths per CC (20 years vaccine protection). Scenarios based on increasing VCR with CI are the most cost-effective. Conclusions The study quantifies the increased risk of CC-related outcomes associated with current sub-optimal VCR and the possible investment to implement actions in order to improve the efficiency of the current strategies and tackle health inequalities (communication campaign, actions toward underserved women). Key messages Improving HPV vaccination uptake is a cost-effective measure, even considering only the cervical cancer prevention. Including health inequalities participation in modeling is crucial as underserved women are both less vaccinated and screened.

scholarly journals Vaccination against HPV: Theoretical Aspects and Practical Results of Cervical Cancer Prevention

2020 ◽  
Vol 18 (6) ◽  
pp. 98-108
Author(s):  
N. V. Zarochentseva ◽  
O. I. Trushina ◽  
E. G Novikova ◽  
I. I. Baranov ◽  
P. D. Lopukhov ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Precancerous Lesions ◽  
Hpv Vaccination ◽  
Well Being ◽  
Hpv Infection ◽  
Research Area ◽  
Cervical Cancer Prevention ◽  
Steady Increase ◽  
Vaccination Programs

Relevance. Cervical cancer (CC) continues to be the focus of attention of oncologists all over the world due to the fact that the incidence of it over the past decades has not tended to decrease. The steady increase in morbidity, high mortality rates, and the tendency to «rejuvenate» the disease, the relatively low detection rate of the early stages of the disease due to poor results of cytological screening predetermine the search for new scientifically based approaches to solving cervical cancer problems. A promising direction for the prevention of squamous cell carcinoma and adenocarcinoma associated with human papillomavirus (HPV) is prophylactic vaccination against HPV, the need for which is due to the role of HPV infection in carcinogenesis processes.The aim of this article is to summarize the currently available data on advances in the prevention of precancerous lesions and cervical cancer, primarily through vaccination against HPV infection.Conclusions. The creation of vaccines for the prevention of oncogenic HPV types is a significant achievement in the biomedical research area. The successful development of a group of vaccines, which can confidently be called the vaccines of the 21st century, gives us hope that modern medicine has the potential to reduce population cancer risk and reduce the likelihood of early onset of cervical cancer. Demonstration of the efficacy and feasibility of routine HPV vaccination programs in a number of countries demonstrates encouraging progress in solving cervical cancer problems. Vaccination against HPV will not only ensure epidemiological well-being, but also lead to a decrease in morbidity and mortality from such a terrible complication of human papillomavirus infection – cervical cancer.

scholarly journals Awareness of knowledge about the problem of human papillomavirus infections and HPV vaccination in a group of female students beginning their studies at universities in Lublin

2016 ◽  
Vol 126 (4) ◽  
pp. 175-178
Author(s):  
Gustaw Chołubek ◽  
Krzysztof Wiktor ◽  
Karolina Małek ◽  
Dorota Robak-Chołubek
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Research Group ◽  
Precancerous Lesions ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Female Students ◽  
Papillomavirus Infections ◽  
Study Results

Abstract Introduction. HPV infection is one of the most common type of sexually transmitted infections and it is a significant epidemiological problem all over the world. The risk of infection persistence and its progression to pathological, precancerous lesions depends on HPV type. Vaccinations against HPV virus are one of the elements of the prophylactic program and allow for early detection of cervical cancer. Aim. Aim of the study was analysis of awareness of problems of human papillomavirus infections and cervical cancer prevention, including vaccinations against HPV among female students commencing studies in Lublin. Material and methods. The research group included 400 women selected at random, all starting their studies at five universities in Lublin. The research group was supposed to show some general knowledge of the problem of cervical cancer among young women. It was also to define how many of them benefited from the prophylaxis of getting a vaccination against HPV. The scientific tool was individually elaborated survey questionnaire. Obtained study results were then subject to statistical analysis. Results. The majority of respondents were not vaccinated against HPV – only 2.5% of the surveyed confirmed that they had been vaccinated. The surveyed students most frequently evaluated their knowledge on prevention of HPV cervical cancer as poor. The surveyed who admitted having information about HPV and cervical cancer prophylaxis during their classes at school significantly more frequently had high level of knowledge than women who claimed not to obtain such information at school (p=0.002). Conclusions. It might make sense to conduct planned comparative studies in the centers practicing population vaccinations among girls aged 12-13 and not practicing such primary prophylaxis with cytological follow-ups. It may allow to elaborate the effective model of cervical cancer prophylaxis based on early educational activities, both on primary and secondary prophylaxis.

scholarly journals Impact of Delaying Effective and Cost-Effective Policy Decisions: An Example From Cervical Cancer Prevention in Norway

2022 ◽  
Vol 7 (1) ◽  
pp. 238146832110710
Author(s):  
Allison Portnoy ◽  
Mari Nygård ◽  
Lill Trogstad ◽  
Jane J. Kim ◽  
Emily A. Burger
Keyword(s):  
Cervical Cancer ◽  
Precancerous Lesions ◽  
Cost Effective ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Prevention Policy ◽  
Policy Decisions ◽  
Policy Changes ◽  
Effective Interventions ◽  
Prophylactic Vaccination

Introduction. Delayed implementation of evidence-driven interventions has consequences that can be formally evaluated. In Norway, programs to prevent cervical cancer (CC)—screening and treatment of precancerous lesions and prophylactic vaccination against human papillomavirus (HPV) infection—have been implemented, but each encountered delays in policy implementation. To examine the effect of these delays, we project the outcomes that would have been achieved with timely implementation of two policy changes compared with the de facto delays in implementation (in Norway). Methods. We used a multimodeling approach that combined HPV transmission and cervical carcinogenesis to estimate the health outcomes and timeline for CC elimination associated with the implementation of two CC prevention policy decisions: a multicohort vaccination program of women up to age 26 years with bivalent vaccine in 2009 compared with actual “delayed” implementation in 2016, and a switch from cytology to primary HPV-based testing in 2015 compared with “delayed” rollout in 2020. Results. Timely implementation of two policy changes compared with current Norwegian prevention policy timeline could have averted approximately 970 additional cases (range of top 10 sets: 830–1060) and accelerated the CC elimination timeline by around 4 years (from 2039 to 2035). Conclusions. If delaying implementation of effective and cost-effective interventions is being considered, the decision-making process should include quantitative analyses on the effects of delays.

scholarly journals Precision Prevention: The 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors

2021 ◽  
Vol 2 (3) ◽  
pp. 274-280
Author(s):  
Ritu Nayar
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cancer Prevention ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Management Strategies ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Screening Tests ◽  
Consensus Guidelines

The approach to cervical cancer prevention has evolved significantly over the past two decades. HPV immunization has decreased the specificity of screening modalities and HPV-based testing has been replacing our previously successful morphology-only approach. Additionally, there is much more emphasis on providing precision prevention, rather than the previously used “one-fits-all” management strategies. A number of new biomarkers are entering clinical practice and being integrated into cervical cancer screening and management in order to enable a more personalized assessment of the risk for precancer/cancer for an individual patient. The 2019 ASCCP Risk-Based Management Consensus Guidelines expand on the concept of “equal management for equal risk”. They consider a patient’s history in addition to current test results to provide recommendations for increased surveillance/treatment in patients at higher risk for CIN3+ while minimizing interventions for lower-risk patients who have new versus persistent HPV infection. Clinical management decisions are based on immediate risk and 5-year risk estimates for CIN3+, which are determined by referencing an extensive risk table compiled by the National Cancer Institute (NCI). The course of action for a given patient is recommended by comparison of the risk in the risk database, to the predetermined clinical action thresholds. These guidelines address the need for simplification and offer some stability for the provider while being conducive to the incorporation of anticipated continued technologic advances in methods for cervical cancer prevention. Their enduring nature will allow for changes needed based on risk reduction as HPV vaccination uptake increases and vaccinated women reach screening age. Similarly, the design allows for the addition of new tests into the risk assessment calculations after their approval by applicable regulatory agencies and review/consensus approval by the ASCCP new technology and enduring guidelines workgroups. As cytopathologists, we must be familiar with the scientific advancements in primary and secondary prevention, evolving screening and management guidelines, and participate actively in the multidisciplinary approach for the prevention of cervical cancer.

scholarly journals Prevalence and genotype distribution of HPV and cervical pathological results in Sichuan Province, China: a three years surveys prior to mass HPV vaccination

2020 ◽  
Author(s):  
Qing Luo ◽  
Ni Jiang ◽  
Qiaoyuan Wu ◽  
Jiaqiang Wang ◽  
Jialing Zhong
Keyword(s):  
Cervical Cancer ◽  
Prevention And Control ◽  
Control Strategies ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Health Examination ◽  
Genotype Distribution ◽  
Screening Population ◽  
And Control

Abstract Background HPV persistent infection is a strong carcinogenic factor to induce cervical cancer. Investigation of HPV epidemiology and genotype distribution is meaningful for the development cervical cancer prevention and control strategies. Methods By using PCR-based hybridization gene chip assay, HPV genotype was detected of 14185 women that came from HEC (Health Examination Center) or OGOC (Obstetrics and Gynecology Outpatient Clinics) between 2015 and 2017 in Sichuan area. The epidemiology and genotype distribution as well as the relationship to in histology and cytology abnormalities were analysed. Results The positivity of HPV was 23.84%. The HPV-positive rate of OGOC group (37.62%) is significantly higher than that of HEC group (15.29%), p <0.05. The prevalence of HPV reached peak at 41-50 age (5.86%) in HEC group, but at 21-30 age (14.74%) in OGOC group. Of the HPV positive women, single genotype infection was the most common form in both HEC and OGOC group, accounted for 62.06% in total screening population, 74.36% in HEC group and 54.01% in OGOC group. Three most prevalent HPV types were HPV-52 (5.02%), 58 (3.61%), 16 (3.24%) in total screening population. Of the HPV positive women, the top three were HPV-52 (20.93%), CP8304 (15.32%), 58 (14.42%) in HEC group, while were HPV-52 (21.14%), 16 (16.34%), 58 (15.61%) in OGOC group. HPV 52/16/58 accounted for the 41.84% of cytology and 56.52% of histological abnormalities. Conclusions Women in Sichuan area are facing with the great threat of HPV infection, especially the women of 21~30 or 41-50 years old. HPV 52, 58, 16 were the priority HPV type in OGOC group, while in in HEC group is HPV 52, CP8304, 58. HPV 52/16/58 accounted for the majority of cytology and histological abnormalities. These accurate data could provide a scientific basis for the prevention and control strategies of cervical cancer in Sichuan area.

scholarly journals “Human Papilloma Virus Vaccination for cervical cancer prevention. Is it safe and effective?”

2018 ◽  
Vol 17 (3) ◽  
pp. 329-336
Author(s):  
Damitha Asanga Gunawardane
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Reproductive Tract ◽  
Screening Program ◽  
Cervical Screening ◽  
Hpv Vaccination ◽  
Medical Science ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Hpv Vaccines

Human papillomavirus (HPV) causes cervical cancer, which is the fourth most common cancer in women. Most of the cervical cancers are linked to genital infection with HPV and it is the most common viral infection of the reproductive tract. At present, there are three types of HPV vaccines available. Even though HPV vaccination is a primary prevention tool, that does not eliminate the need for routine cervical screening, since the vaccines do not protect against all high-risk HPV types. Ninety percent of HPV infections have no clinical consequences at all whether they are high-risk or low-risk subtypes of HPV. All three types of HPV vaccines have very high vaccine efficacy for prevention of HPV infection among females aged 14 to 26 years. Proper assessment of the safety of HPV vaccine is a problem even after proper systematic review since the most of the clinical trials on the safety of the vaccines were used Hepatitis A vaccine or high immunogenicity enhancing aluminium adjuvant as their placebo. HPV vaccination would be very cost effective for the countries when there is no cervical screening program or if the programme coverage is very poor.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.329-336

From HPV Infection to Lesion Progression: The Role of HLA Alleles and Host Immunity

2019 ◽  
Vol 63 (2) ◽  
pp. 148-158 ◽  
Author(s):  
Anna Paaso ◽  
Anna Jaakola ◽  
Stina Syrjänen  ◽  
Karolina  Louvanto
Keyword(s):  
Cervical Cancer ◽  
T Cell ◽  
Cell Response ◽  
Precancerous Lesions ◽  
Hla Class I ◽  
Hpv Infection ◽  
T Cell Response ◽  
Class I ◽  
Hla Alleles ◽  
Increased Risk

Persistent high-risk human papillomavirus (HPV) infection has been associated with increased risk for cervical precancerous lesions and cancer. The host’s genetic variability is known to play a role in the development of cervical cancer. The human leukocyte antigen (HLA) genes are highly polymorphic and have shown to be important risk determinants of HPV infection persistence and disease progression. HLA class I and II cell surface molecules regulate the host’s immune system by presenting HPV-derived peptides to T-cells. The activation of T-cell response may vary depending on the HLA allele polymorphism. The engagement of the T-cell receptor with the HPV peptide-HLA complex to create an active costimulatory signal is essential for the activation of the T-cell response. Functional peptide presentation by both HLA class I and II molecules is needed to activate efficient helper and effector T-cell responses in HPV infection recognition and clearance. Some of these HLA risk alleles could also be used as preventive tools in the detection of HPV-induced cervical lesions and cancer. These HLA alleles, together with HPV vaccines, could potentially offer possible solutions for reducing HPV-induced cervical cancer as well as other HPV-related cancers.

scholarly journals Complementary and Innovative Method in Genital HPV Testing for Cervical Cancer Prevention

2020 ◽  
Vol 25 (4) ◽  
pp. 54-56
Author(s):  
Georgeta Gînfălean
Keyword(s):  
Cervical Cancer ◽  
Precancerous Lesions ◽  
Screening Method ◽  
Transmitted Disease ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Hpv Testing ◽  
Female Population ◽  
Innovative Method ◽  
Prevention Programmes

Abstract Considering actual SARS-COV 2 pandemic, the comfort and time of the female patient’ trend is to minimize the time spent in the doctor’s office, so that auto-testing is a solving problem in this context. This paper aims at the importance of self-collected urine and vaginal samples, since actual studies are showing that is a complementary method in HPV-testing and a screening method for prevention of cervical cancer. Genital HPV infection is responsible for approximately 99% of cervical cancers, and is considered a sexually transmitted disease. Given that eight out of ten patients have at least one episode of HPV infection in their lifetime, there is a need for a method of early detection of genital HPV infection. Cervical cancer is the second type of diagnosed cancer in the rank of genital cancers and the third leading cause of cancer death among the female population. In Romania, the frequency of cervical cancer and mortality caused by this type of cancer remains high. In 2018 Globocan, it was mentioned that the occurrence of cervical cancer in Romania was 8.6%, and the mortality was 19.5/10,000 women. Worldwide, the following have been implemented: primary prevention programmes (via immunization) and secondary prevention programmes – traditional cytological testing, to which co-tests have been added. In the co-testing sector, there has been found with an updated visa – the self-harvesting test, being considered a complementary and innovative method in genital HPV testing, which aims to: identify the presence of highly oncogenic HPV strains with a marked sensitivity. Self-harvesting testing aims to: signal the presence of highly oncogenic strains, extrapolation can lead to early identification of the number of cases of precancerous lesions of the cervix and implicitly of cervical cancer.

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