Controlled trial of cervical cancer screening frequency among human-papillomavirus-vaccinated women
(2025) In International Journal of Cancer- Abstract
Cervical screening frequency has not been studied in vaccinees. As the major risk factor, oncogenic human papillomavirus (HPV) is declining due to vaccination. We report a trial to assess the effectiveness of cervical screening frequency among women HPV-vaccinated as early adolescents (NCT02149030). In 2013, 5626 1992-1995-born women, who had received three doses of the HPV16/18 vaccine at ages 12–15 between 2007 and 2010 in a community-randomized vaccination trial (NCT00534638), were allocated at age 22 into high-intensity cytology-based cervical screening by even birth date (Arm A1) or into low-intensity cytology-based cervical screening by odd birth date (Arm A2). One thousand three hundred thirty-three women who received HPV16/18... (More)
Cervical screening frequency has not been studied in vaccinees. As the major risk factor, oncogenic human papillomavirus (HPV) is declining due to vaccination. We report a trial to assess the effectiveness of cervical screening frequency among women HPV-vaccinated as early adolescents (NCT02149030). In 2013, 5626 1992-1995-born women, who had received three doses of the HPV16/18 vaccine at ages 12–15 between 2007 and 2010 in a community-randomized vaccination trial (NCT00534638), were allocated at age 22 into high-intensity cytology-based cervical screening by even birth date (Arm A1) or into low-intensity cytology-based cervical screening by odd birth date (Arm A2). One thousand three hundred thirty-three women who received HPV16/18 vaccination at age 18 attended a safety of low intensity-screening arm (Arm A3). Low-intensity screening, where low-grade cytological abnormalities were not revealed for 6 years, was compared to the standard high-intensity screening used in Finland at the time. The prevalence of cytological and HPV findings was calculated at ages 22/25/28. The hazard ratio of histopathologically confirmed immediate cervical cancer precursors (HSIL/CIN2+) among participants was compared between low- and high-intensity screening arms. The overall occurrence of CIN2+ was comparable in Arms A1, 0.70% and A2, 0.66%, with the corresponding hazard ratio at age 28 being 0.97 (95% confidence intervals, 0.50–1.88). By age 28, the occurrence of vaccine-HPV types 16/18 was reduced up to 88% in the 12-to-15 compared to 18-year-old HPV-vaccinated women. In conclusion, the risk of CIN2+ was similar for HPV-vaccinated women who attended low-intensity cervical screening compared to high-intensity screening most likely due to the decline of oncogenic HPVs.
(Less)
- author
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- cervical screening, HPV-vaccination, RCT
- in
- International Journal of Cancer
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:41203578
- scopus:105021314374
- ISSN
- 0020-7136
- DOI
- 10.1002/ijc.70229
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2025 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
- id
- 3ccbb43b-9d05-4494-87d0-a027813532c8
- date added to LUP
- 2025-12-19 14:35:30
- date last changed
- 2025-12-19 14:36:46
@article{3ccbb43b-9d05-4494-87d0-a027813532c8,
abstract = {{<p>Cervical screening frequency has not been studied in vaccinees. As the major risk factor, oncogenic human papillomavirus (HPV) is declining due to vaccination. We report a trial to assess the effectiveness of cervical screening frequency among women HPV-vaccinated as early adolescents (NCT02149030). In 2013, 5626 1992-1995-born women, who had received three doses of the HPV16/18 vaccine at ages 12–15 between 2007 and 2010 in a community-randomized vaccination trial (NCT00534638), were allocated at age 22 into high-intensity cytology-based cervical screening by even birth date (Arm A1) or into low-intensity cytology-based cervical screening by odd birth date (Arm A2). One thousand three hundred thirty-three women who received HPV16/18 vaccination at age 18 attended a safety of low intensity-screening arm (Arm A3). Low-intensity screening, where low-grade cytological abnormalities were not revealed for 6 years, was compared to the standard high-intensity screening used in Finland at the time. The prevalence of cytological and HPV findings was calculated at ages 22/25/28. The hazard ratio of histopathologically confirmed immediate cervical cancer precursors (HSIL/CIN2+) among participants was compared between low- and high-intensity screening arms. The overall occurrence of CIN2+ was comparable in Arms A1, 0.70% and A2, 0.66%, with the corresponding hazard ratio at age 28 being 0.97 (95% confidence intervals, 0.50–1.88). By age 28, the occurrence of vaccine-HPV types 16/18 was reduced up to 88% in the 12-to-15 compared to 18-year-old HPV-vaccinated women. In conclusion, the risk of CIN2+ was similar for HPV-vaccinated women who attended low-intensity cervical screening compared to high-intensity screening most likely due to the decline of oncogenic HPVs.</p>}},
author = {{Ortega Llobet, Mònica and Gray, Penelope and Baussano, Iacopo and Elfström, K. Miriam and Eriksson, Tiina and Lagheden, Camilla and Nieminen, Pekka and Söderlund-Strand, Anna and Dillner, Joakim and Pimenoff, Ville N. and Lehtinen, Matti}},
issn = {{0020-7136}},
keywords = {{cervical screening; HPV-vaccination; RCT}},
language = {{eng}},
publisher = {{John Wiley & Sons Inc.}},
series = {{International Journal of Cancer}},
title = {{Controlled trial of cervical cancer screening frequency among human-papillomavirus-vaccinated women}},
url = {{http://dx.doi.org/10.1002/ijc.70229}},
doi = {{10.1002/ijc.70229}},
year = {{2025}},
}