TY - JOUR T1 - HPV-FASTER: broadening the scope for prevention of HPV-related cancer. JF - Nat Rev Clin Oncol Y1 - 2016 A1 - Bosch, F Xavier A1 - Robles, Claudia A1 - Diaz, Mireia A1 - M. Arbyn A1 - Baussano, Iacopo A1 - Clavel, Christine A1 - Ronco, Guglielmo A1 - Dillner, Joakim A1 - Lehtinen, Matti A1 - Petry, Karl-Ulrich A1 - Poljak, Mario A1 - Kjaer, Susanne K A1 - Meijer, Chris J L M A1 - Garland, Suzanne M A1 - Salmerón, Jorge A1 - Castellsagué, Xavier A1 - Bruni, Laia A1 - de Sanjosé, Silvia A1 - Cuzick, Jack KW - Adult KW - Early Detection of Cancer KW - Female KW - Human papillomavirus 16 KW - Human papillomavirus 18 KW - Humans KW - Mass Screening KW - middle aged KW - Papillomavirus Infections KW - Papillomavirus Vaccines KW - Sensitivity and Specificity KW - Uterine Cervical Neoplasms KW - Vaccination KW - Young adult AB -

Human papillomavirus (HPV)-related screening technologies and HPV vaccination offer enormous potential for cancer prevention, notably prevention of cervical cancer. The effectiveness of these approaches is, however, suboptimal owing to limited implementation of screening programmes and restricted indications for HPV vaccination. Trials of HPV vaccination in women aged up to 55 years have shown almost 90% protection from cervical precancer caused by HPV16/18 among HPV16/18-DNA-negative women. We propose extending routine vaccination programmes to women of up to 30 years of age (and to the 45-50-year age groups in some settings), paired with at least one HPV-screening test at age 30 years or older. Expanding the indications for HPV vaccination and much greater use of HPV testing in screening programmes has the potential to accelerate the decline in cervical cancer incidence. Such a combined protocol would represent an attractive approach for many health-care systems, in particular, countries in Central and Eastern Europe, Latin America, Asia, and some more-developed parts of Africa. The role of vaccination in women aged >30 years and the optimal number of HPV-screening tests required in vaccinated women remain important research issues. Cost-effectiveness models will help determine the optimal combination of HPV vaccination and screening in public health programmes, and to estimate the effects of such approaches in different populations.

VL - 13 CP - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26323382?dopt=Abstract M3 - 10.1038/nrclinonc.2015.146 ER -