For the coming decades, screening remains an important preventative instrument along with vaccination but the need for screening decreases when vaccine uptake increases and vaccines cover a broad spectrum of HPV types. Evidence on how to screen vaccinated women need to be based on real-life data and transparent cost-effectiveness analyses.
An overview will be given of data sources that can be used to develop screening strategies for vaccinated women. Data sources include: (1) randomized screening trials performed in vaccinated women, (2) screening trials and cohort studies in which the occurrence of prevalent and incident genotype-specific HPV infections and CIN is estimated, and (3) screening and vaccination registries.The information from different sources can be synthesized by means of a model that informs about the cost-effectiveness of different screening strategies. Specifically, it will be illustrated by means of POBASCAM screening trial data collected over two successive screening rounds (resource type 2) how screening lifetime projections of HPV infection and CIN2+ risks can be obtained under different vaccination strategies (first- and second-generation vaccines, adolescent and adult vaccination).
The main questions for public health decision makers are how to set up a screening program for vaccinated cohorts when vaccine uptake is limited, how to screen cohorts with unvaccinated women and women vaccinated with first- and second-generation vaccines, and which events require screening protocols to be updated.
SESSION TITLE:
The future of screening: primary HPV testing in increasingly vaccinated populations