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• A new study out of Norway suggests changes to the cervical cancer screening program based on the widespread uptake of the human papillomavirus (HPV) vaccine. 
• The findings show that across all age groups, less frequent screening with longer intervals was preferred. 
• The authors suggest that females ages 12 to 24 who’ve received the HPV shot may only require cervical cancer screening every 15 to 25 years, or two to three times in their lifetimes.

The human papillomavirus (HPV) is a group of 200 viruses, many of which are spread by sexual activity.

Some of these viruses are referred to as high risk and may cause cervical cancer. In fact, nearly all cases of cervical cancer are due to long-lasting infection with high risk HPV. 

A new study from researchers in Norway suggests that due to the widespread uptake of HPV vaccines, the screening program for cervical cancer may be able to be updated. The findings were published on February 3 in the Annals of Internal Medicine.

The researchers say they “wanted to evaluate different strategies to screen for cervical cancer less often.”

They considered cost-effectiveness and the tradeoffs of benefits and potential harms. They examined these strategies by age at HPV vaccination and vaccine type.

They found that for females who received the vaccine at a younger age, screening just two or three times in a lifetime was both cost-effective and associated with fewer unnecessary follow-up procedures.  

HPV shot protects against cervical cancer

The HPV vaccine can help prevent HPV infection, which in turn helps prevent cervical cancer.

According to the Centers for Disease Control and Prevention (CDC), HPV causes around 36,000 cases of cancer in the United States each year. 

The HPV vaccine is typically recommended for children between the ages of 11 and 12. They should receive their first dose during this time, and a second dose between 6 and 12 months after the first. 

If you were not vaccinated at this age, it’s still possible to receive the HPV vaccine up to age 26. If you receive the vaccine later (between ages 15 and 26), you will require three doses. 

The study authors wrote that with advances in cervical cancer intervention, like the HPV vaccine, the screening guidelines should be continuously adapted. 

“In a population with lower cervical cancer risk, like HPV vaccination prior to exposure, the reduced screenings would decrease unnecessary diagnostic procedures and treatments while still maintaining cervical cancer prevention,” said Amy Roskin, MD, board certified OB-GYN and chief medical officer at Seven Starling, a women’s health platform, who was not involved in the study. 

As of 2020, 55% of countries worldwide had introduced the HPV vaccine. The goal is to reach 90% coverage by 2030. This goal has been set as part of an approved global strategy to eliminate cervical cancer as a public health issue. 

With this widespread use of the HPV vaccine, the research team suggested that females ages 12 to 24 who receive the vaccine may be able to have fewer cervical cancer screenings. 

Current cervical screening guidelines

The American Cancer Society (ACS) recommends that anyone with a cervix should begin regular cervical cancer screenings at 25 years old, and continue them until at least 65 years old. 

“Patients should know that the criteria for stopping screening have changed — they now need negative HPV tests at both ages 60 and 65 years to safely exit screening, rather than the previous less stringent requirements,” Ryan Kahn, MD, a gynecologic oncologist at Baptist Health Miami Cancer Institute, part of Baptist Health South Florida, who was not invovled in the study, told Healthline in an earlier interview.

The ACS states that individuals should receive these screenings every three to five years, depending on the type of test: 

• Primary HPV screening via healthcare professional: Every 5 years
• Self-collected HPV testing: Every 3 years
• Co-testing done in combination with Pap Smear: Every 5 years
• Pap test alone (if no other options are available): Every 3 years

The recent study suggested that for those who receive the HPV vaccine between the ages of 12 and 24, screenings could be done once every 15 to 25 years. This equates to only two or three screenings a person’s lifetime. 

However, the research team also noted that this should be decided on an individual basis.

There are certain people who may be at a higher risk of developing cervical cancer. For these individuals, more frequent screening may be necessary. This may include: 

• individuals with a prior history of abnormal screenings
• those with has a history of cervical cancer
• people at a higher risk for cervical cancer due to a weakened immune system
• anyone who was exposed to diethylstilbestrol (DES) before birth

“The study was based in Norway, where they have an organized screening program and a nationwide registry for vaccination,” Roskin told Healthline.

“I’m not sure how well we can transfer the reduced screening guidelines to the US at this point, since we don’t have a national registry or a specific, organized national screening program. More information and studies are definitely needed.”

Who should get vaccinated against HPV? 

The CDC recommends that anyone ages 11 and 12 should receive the HPV vaccine. The agency also advises the shot for anyone up to age 26 who hasn’t yet received it.

There are certain people who shouldn’t get vaccinated against HPV. These include: 

• those who’ve had an allergic reaction to vaccine ingredients or to a previous dose of the vaccine
• anyone who has an allergy to yeast
• people who are pregnant

“According to the American College of Obstetricians and Gynecologists, HPV vaccines are ‘among the most effective vaccines available worldwide,’” Roskin said.

“The [new] study reaffirms this and provides important information about how these results could inform screening recommendations and guidelines.”