Women vaccinated against the human papillomavirus (HPV) may require significantly fewer cervical cancer screenings than currently recommended, according to a new modeling study published in , in the Annals of Internal Medicine. The research suggests that for those vaccinated before the age of 30, as few as two or three screenings over a lifetime may be sufficient.
Understanding HPV and Cervical Cancer
Cervical cancer is strongly linked to infection with high-risk types of HPV, a very common sexually transmitted infection that is often asymptomatic. Nearly all cases of cervical cancer are caused by persistent infection with these high-risk HPV strains. The National Health Service (NHS) in England currently invites individuals with a cervix aged 24 to 64 for routine screening every five years and offers the HPV vaccine to all children aged 12 to 13.
The Study and Its Findings
Researchers from Norway’s University of Oslo and Harvard T.H. Chan School of Public Health utilized government health data from Norway to model the health impacts and cost-effectiveness of different cervical cancer screening strategies. They analyzed hypothetical cohorts of women vaccinated in seven different age groups – 12, 13-15, 16-18, 19-21, 22-24, 25-27, and 28-30 years – and with either bivalent or nonavalent HPV vaccines.
The modeling consistently showed that less frequent screening, with longer intervals between tests than the current five-year recommendation, was preferable across all vaccination age groups and vaccine types. This preference was defined by a cost-effectiveness threshold of 55,000 USD per quality-adjusted life-year. Importantly, the age at which vaccination was received significantly impacted the optimal screening frequency.
Specifically, the study found that those vaccinated between the ages of 25 and 30 could safely undergo screening only once every 10 years. For individuals vaccinated between 19 and 21, a 20-year interval between screenings (starting at age 25) was deemed appropriate. And those vaccinated before the age of 19 could potentially go 25 years between screenings.
the researchers determined that for women vaccinated between the ages of 12 and 24, screening every 15 to 25 years – equating to just two or three screenings throughout their lifetime – represented a preferred strategy.
Implications for Screening Programs
These findings suggest a potential shift in how cervical cancer screening programs are designed and implemented. Currently, screening guidelines do not typically differentiate based on HPV vaccination status. This study highlights the possibility of tailoring screening recommendations to reflect the reduced risk conferred by vaccination.
The researchers emphasize that optimal screening programs likely involve less frequent testing for women vaccinated against HPV by age 30, with the specific frequency adjusted based on the age at vaccination and the type of HPV vaccine received.
Important Considerations and Future Research
The study authors acknowledge certain limitations. The analysis did not include unvaccinated women, although they note that these individuals may still benefit from herd immunity resulting from widespread vaccination. The researchers caution that further research is needed before screening recommendations are altered, and that individual patient vulnerabilities should always be considered.
It’s crucial to remember that this study focused on modeling and did not directly assess clinical outcomes. While the results are promising, they need to be validated through further investigation and real-world implementation studies.
The findings underscore the significant public health impact of HPV vaccination. By preventing HPV infection, the vaccine not only reduces the risk of cervical cancer but may also allow for a more efficient and less burdensome screening process for vaccinated individuals.
As of , health officials have not yet issued updated screening guidelines based on these findings, but the study provides a strong rationale for re-evaluating current practices.
Reference
Pedersen K et al. Optimizing cervical cancer screening by age at vaccination for human papillomavirus: Health and resource implications. Ann Intern Med. 2026;DOI:10.7326/ANNALS-25-03192.
National Health Service (NHS) England. Cervical screening: programme overview. 2015. Available at: https://www.gov.uk/guidance/cervical-screening-programme-overview. Last accessed: .
National Health Service (NHS) England. Causes of cervical cancer. 2024. Available at: https://www.nhs.uk/conditions/cervical-cancer/causes/. Last accessed: .
