There are now a variety of tools for cervical cancer prevention. HPV vaccination and screening programs are in place in several settings, however coverage is often sub-optimal. Improving participation is important, but improving vaccine uptake will involve different approaches to those required to increase screening participation or adherence to recommended follow-up. To assist in prioritizing and resourcing efforts, here we explore the impact of different potential improvements to participation in cervical cancer prevention programs, and which improvements would have the greatest impact.
Using a well-established model of HPV transmission, vaccination, natural history and screening, we assessed the relative impact of several improvements to HPV vaccination and screening participation, using Australia as an example. These improvements included: i) increasing HPV vaccine coverage in females (from current 78%); ii) increasing HPV vaccine coverage in females and males (current male coverage 72%); iii) reducing the proportion of women never screened; iv) increasing screening participation at the recommended interval; v) improving attendance for follow-up by women under surveillance following a previous abnormal screening test. The impact of improvements in screening participation were assessed separately for cohorts offered vaccination and for unvaccinated cohorts.
The findings of this analysis will provide important information about how to prioritise efforts in increasing participation in cervical cancer prevention programs.