Nav: Home

Cervical cancer screening could be less frequent, start later

October 17, 2016

Boston, MA - Women may only need cervical cancer screening every 5-10 years--instead of every three years, as currently recommended--and may be able to start the screenings later in life, according to a new study from Harvard T.H. Chan School of Public Health.

The researchers found that less-intensive screening is needed among women who have been vaccinated against human papillomavirus (HPV), which causes almost all cases of cervical cancer, because the risk of these women developing cervical cancer is quite low.

The study will appear October 17, 2016, in the Journal of the National Cancer Institute (JNCI).

"This analysis enabled us to examine what would happen if we shifted from the current way we screen for cervical cancer--essentially, recommending the same type of screening for all women--to screening that takes into account whether women have been vaccinated against HPV and therefore face a substantially lower risk of cervical cancer," said Jane Kim, professor of health decision science at Harvard Chan School. "We found that continuing intensive screening among HPV-vaccinated women yields excessive costs and harms with little to no health benefit."

Since 2012, major guideline-making organizations have recommended that all women in the U.S. be screened for cervical cancer every three years beginning at age 21 with a Pap test (which checks for abnormal cells in the cervix), with the option of switching to a combination of Pap test and HPV testing (known as "cotesting") every five years beginning at age 30. However, current U.S. guidelines don't differentiate screening recommendations based on a woman's HPV vaccination status.

The Harvard Chan researchers developed a disease simulation model to estimate the risks and benefits of various screening protocols. Their model projected the health and economic effects of three different types of HPV vaccines that are currently approved for use, two of which have been available since 2006. The goal was to pinpoint screening strategies that would provide the biggest health benefit in the most cost-effective way.

According to the model, women with the lowest risk of cervical cancer--those vaccinated with the new "nonavalent" HPV vaccine (HPV-9), which targets seven types of HPV that cause nearly 90% of all cervical cancers--would only need screening four times in their life, every 10 years, starting at age 30 or 35. Women vaccinated with earlier versions of the HPV vaccine--the bivalent and quadrivalent vaccines (HPV-2 and HPV-4), which target two HPV types that cause roughly 70% of cervical cancers--would need screening every five years starting at age 25 or 30.

The researchers also found that screening with HPV testing alone would provide similar health benefits and value as a Pap test or cotesting, because the HPV test is highly sensitive and can more efficiently identify women who are likely to develop cervical cancer.

One limitation of the study is that it modeled scenarios in which women are fully vaccinated in pre-adolescence (as recommended) and fully compliant with screening protocols. The researchers noted that future studies should take into account actual vaccination uptake rates in the population and data on screening compliance in vaccinated women as these data become available over time.
-end-
Other Harvard Chan School researchers involved in the study included postdoctoral research fellow Emily Burger, programmer Stephen Sy, and Nicole Campos, research scientist.

The study was supported by the National Cancer Institute of the National Institutes of Health (R01CA160744).

"Optimal cervical cancer screening in women vaccinated against human papillomavirus," Jane J. Kim, Emily A. Burger, Stephen Sy, Nicole G. Campos, Journal of the National Cancer Institute, October 17, 2016, doi: 10.1093/jnci/djw216

Visit the Harvard Chan School website for the latest news, press releases, and multimedia offerings.

Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people's lives--not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America's oldest professional training program in public health.

Harvard T.H. Chan School of Public Health

Related Cervical Cancer Articles:

How have HPV vaccines affected cervical cancer screening?
A new review looks at cervical cancer screening in the era of HPV vaccination.
New tech promises easier cervical cancer screening
Duke University researchers have developed a handheld device for cervical cancer screening that promises to do away with uncomfortable speculums and high-cost colposcopes.
Women should continue cervical cancer screening as they approach age 65
While current guidelines indicate that cervical cancer screening can be stopped for average risk patients after age 65, many women lack the appropriate amount of screening history to accurately assess their risk.
$1.5 million grant to prevent cervical cancer in West Texas
Navkiran Shokar, M.A., M.P.H, M.D., has received nearly $1.5 million from the Cancer Prevention and Research Institute of Texas (CPRIT) to reduce the burden of cervical cancer in West Texas.
Study finds not all women get appropriate care for cervical cancer
Fewer than three out of five women with cervical cancer received guideline-based care, a new study finds.
Cervical cancer mortality rates may be underestimated
A new analysis reveals that for most women, the risk of dying from cervical cancer is higher than previously thought.
Cervical cancer screening could be less frequent, start later
Women may only need cervical cancer screening every 5-10 years -- instead of every three years, as currently recommended -- and may be able to start the screenings later in life, according to Harvard T.H.
Pap screenings linked to less cervical cancer in elderly women
A new study from the University of Illinois confirms a link between Pap smear screenings and a lower risk of developing cervical cancer in women over age 65.
Lupus confirmed as risk factor for cervical cancer
Lupus confirmed as risk factor for cervical cancer
'This enormous burden': Controlling cervical cancer in Latin America
Cervical cancer is an 'enormous burden' for Latin-American society, and the third leading cause of cancer deaths among women in the region, say Dr.

Related Cervical Cancer Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Jumpstarting Creativity
Our greatest breakthroughs and triumphs have one thing in common: creativity. But how do you ignite it? And how do you rekindle it? This hour, TED speakers explore ideas on jumpstarting creativity. Guests include economist Tim Harford, producer Helen Marriage, artificial intelligence researcher Steve Engels, and behavioral scientist Marily Oppezzo.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".