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HPV testing and vaccination could cut cervical screening to twice in a lifetime

Women who have had the human papillomavirus (HPV) vaccine could need only two HPV screening tests for the rest of their lives according to new calculations being presented at the NCRI Cancer Conference in Liverpool.

HPV testing is a more accurate cervical screening method than the current smear test, which looks for abnormal cells.

Professor Peter Sasieni, a Cancer Research UK scientist at Queen Mary, University of London, will urge the UK governments to consider making HPV testing the main method of cervical screening* across the health service as a priority.

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He believes women who have been vaccinated will no longer have to go for screening every three to five years, as is the current practice.

Research suggests that the HPV vaccine will prevent at least seven out of 10 cervical cancers and new vaccines currently being evaluated should prevent even more. It typically takes over 10 years for a cancer to develop after HPV infection. Research shows that cancer caused by HPV types not prevented by the current vaccines take even longer. This could allow the first cervical screen to be safely offered much later than at age 20 or 25.

Professor Sasieni said: “The UK cervical screening programme has done a fantastic job in reducing cervical cancer, but it is based on an old screening test. HPV testing could prevent an even greater proportion of cervical cancer with just half the number of screens over a lifetime. If HPV testing were to be rolled out from next year, it could be used nationally by 2015.

“With continued high coverage of HPV vaccination and targeting of screening resources towards unvaccinated women, cervical cancer should become a truly rare disease. And if the government plan for this change now, they could save hundreds of millions of pounds in the long run.”

Cervical cancer is the second most common cancer among women under the age of 35, and the majority of cases are caused by two strains of HPV, types 16 and 18.

In the UK, girls aged 12 to 13 are offered the HPV vaccine. Girls have three injections over six months given by a nurse. A two year catch up programme also started in autumn 2008 to vaccinate girls aged between 13 and 18.

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “HPV vaccination has been a huge step towards reducing the number of women that will be diagnosed with cervical cancer in future years. And the very high uptake of the vaccine in the UK has been a real success story.

“This is exciting and poses interesting questions for the screening programme in terms of the best way to screen women in the future who have been vaccinated.

“But for now it remains vitally important that all women continue to take up the invitation to go for screening when they receive it.”

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Notes to editors

* If cervical cells test positive for HPV, the sample will then be tested using the current liquid based cytology method.

Professor Sasieni’s recommendations: Screening post vaccination
1. For women vaccinated aged 11 to 14, HPV testing at age 30 and 45
2. For women vaccinated aged 15-23, HPV testing at aged 25 to establish those not protected by vaccine, and further tests at age 35 and 50
3. For women who are not vaccinated or who have only received one dose, HPV testing at age 25, 30, 35, 45, and 55

Current cervical screening
In England:

  • women aged 25-49 are invited for screening every 3 years
  • women aged 50-64 are invited for screening every 5 years
  • women aged 65 or over are only screened if they have not been screened since age 50, or have had recent abnormal results.

In Scotland, women aged 20-60 are invited for screening every 3 years.
In Wales and Northern Ireland, women aged 20-64 are invited for screening every 3-5 years.

About the NCRI Cancer Conference
The National Cancer Research Institute (NCRI) Cancer Conference is the UK’s major forum for showcasing the best British and international cancer research. The Conference offers unique opportunities for networking and sharing knowledge by bringing together world leading experts from all cancer research disciplines. The sixth annual NCRI Cancer Conference is taking place from the 7-10 November 2010 at the BT Convention Centre in Liverpool. For more information visit www.ncri.org.uk/ncriconference

About the NCRI
The National Cancer Research Institute (NCRI) was established in April 2001. It is a UK-wide partnership between the government, charity and industry which promotes co-operation in cancer research among the 21 member organisations for the benefit of patients, the public and the scientific community. For more information visit www.ncri.org.uk
NCRI members are: the Association of the British Pharmaceutical Industry (ABPI); Association for International Cancer Research; Biotechnology and Biological Sciences Research Council; Breakthrough Breast Cancer; Breast Cancer Campaign; Cancer Research UK; CHILDREN with LEUKAEMIA, Department of Health; Economic and Social Research Council; Leukaemia & Lymphoma Research; Ludwig Institute for Cancer Research; Macmillan Cancer Support; Marie Curie Cancer Care; Medical Research Council; Northern Ireland Health and Social Care (Research & Development Office); Roy Castle Lung Cancer Foundation; Scottish Government Health Directorates (Chief Scientist Office); Tenovus; Welsh Assembly Government (Wales Office of Research and Development for Health & Social Care); The Wellcome Trust; and Yorkshire Cancer Research.

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