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Various aspects of the National Cervical Screening Program in Australia could be re-considered over the next few years as a consequence of several factors, including the implementation of HPV vaccination, the availability of new cytology screening technologies and the potential role of primary HPV DNA testing for cervical screening.
Of note, cervical cancer screening was assumed to remain unchanged after the implementation of HPV vaccination.
Following implementation of HPV vaccination, the positive predictive value of cervical cytology will fall alongside the reduction in cytological abnormalities.
Our model shows that early implementation of HPV vaccination attenuates increased risk of HPV infection that accompanies transition to gender-similar sexual behavior.
However, large scale implementation of HPV vaccination is still challenging, and even when effective, it will not override the need for cervical cancer screening.
An increased detection of CIN2+ has been registered after implementation of HPV testing in triage of ASCUS/LSIL in Norway 40.
Similar(41)
However, the high rate of insignificant HPV infections, especially in women under the age of 35 years, has been an impediment to its potential use, so exploring the ability to improve the specificity of hrHPV testing is a crucial step for successful implementation of HPV-based cervical cancer screening (Ronco et al, 2006).
This finding has implications in the eventual implementation of prophylactic HPV vaccines based on HR-HPV types 16 and 18 (Steinbrook, 2006).
It should, however, be emphasised that this study focuses on the clinical situation shortly after implementation of the HPV vaccination, not on the long-term consequences.
Improvement in HIV treatment leading to better survival among the HIV+ further improved the cost-effectiveness of the implementation of a HPV vaccination programme in countries with high HIV prevalence such as South Africa.
Human papilloma virus (HPV) prevalence studies performed in different regions and population groups across Canada would inform public health decisions regarding implementation of anti-HPV vaccines.
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