Advances in cervical cancer prevention: Efficacy, effectiveness, elimination?

Autoři: Karin Sundström aff001;  K. Miriam Elfström aff001
Působiště autorů: Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden aff001;  Regional Cancer Center Stockholm-Gotland, Stockholm, Sweden aff002
Vyšlo v časopise: Advances in cervical cancer prevention: Efficacy, effectiveness, elimination?. PLoS Med 17(1): e1003035. doi:10.1371/journal.pmed.1003035
Kategorie: Editorial
doi: 10.1371/journal.pmed.1003035


With major advances in understanding the infectious etiology of cervical cancer, preventive medicine has obtained highly promising new tools. Human papillomavirus (HPV) vaccines, together with a growing arsenal of HPV-based screening tests, have the potential to radically change public health but require diligent, large-scale implementation to reach the final goal: the elimination of cervical cancer. We reflect here upon the state of cervical cancer prevention globally as there have been several recent developments that will inform this implementation process.

Klíčová slova:

Cancer prevention – Cancer screening – Cancer vaccines – Cervical cancer – Human papillomavirus – Human papillomavirus infection – Vaccination and immunization – Vaccines


1. Meites E, Szilagyi PG, Chesson HW, Unger ER, Romero JR, Markowitz LE. Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68:698–702. doi: 10.15585/mmwr.mm6832a3 31415491

2. National Health Service, United Kingdom. Decision based on the report from The Joint Committee on Vaccination and Immunisation in 2017. [cited 2019 Dec 18]. Available from:

3. International Agency for Research on Cancer. Biological Agents. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 100B. Lyon, France, 2012. p. 270–75.

4. Lehtinen M, Dillner J. Clinical trials of human papillomavirus vaccines and beyond. Nat Rev Clin Oncol. 2013;10(7):400–10. doi: 10.1038/nrclinonc.2013.84 23736648

5. Drolet M, Bénard É, Pérez N, Brisson M; HPV Vaccination Impact Study Group. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis. Lancet. 2019;394(10197):497–509. doi: 10.1016/S0140-6736(19)30298-3 31255301

6. Kim JJ, Goldie SJ. Health and economic implications of HPV vaccination in the United States. N Engl J Med. 2008;359(8):821–32. doi: 10.1056/NEJMsa0707052 18716299

7. Bosch FX, Robles C, Díaz M, Arbyn M, Baussano I, Clavel C, et al. HPV-FASTER: broadening the scope for prevention of HPV-related cancer. Nat Rev Clin Oncol. 2016;13(2):119–32. doi: 10.1038/nrclinonc.2015.146 26323382

8. Elfström KM, Lazzarato F, Franceschi S, Dillner J, Baussano I. Human Papillomavirus Vaccination of Boys and Extended Catch-up Vaccination: Effects on the Resilience of Programs. J Infect Dis. 2016;213(2):199–205. doi: 10.1093/infdis/jiv368 26142436

9. Lehtinen M, Baussano I, Paavonen J, Vänskä S, Dillner J. Eradication of human papillomavirus and elimination of HPV-related diseases—scientific basis for global public health policies. Expert Rev Vaccines. 2019;18(2):153–160. doi: 10.1080/14760584.2019.1568876 30657348

10. World Health Organization (WHO). Executive board, session 144; document EB144/28, 30 January 2019. [cited 2019 Dec 18]. Available from:

11. Hall MT, Simms KT, Lew JB, Smith MA, Brotherton JM, Saville M, et al. The projected timeframe until cervical cancer elimination in Australia: a modelling study. Lancet Public Health. 2019;4(1):e19–e27. doi: 10.1016/S2468-2667(18)30183-X 30291040

12. Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX, et al. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob Health. 2016;4(7):e453–63. doi: 10.1016/S2214-109X(16)30099-7 27340003

13. Foss HS, Oldervoll A, Fretheim A, Glenton C, Lewin S. Communication around HPV vaccination for adolescents in low- and middle-income countries: a systematic scoping overview of systematic reviews. Syst Rev. 2019;8(1):190. doi: 10.1186/s13643-019-1100-y 31370886

14. UNICEF. Human papillomavirus vaccine supply and demand update. UNICEF Supply Division, 2018. [cited 2019 Sep 8]. Available from:

15. Lefèvre H, Moro MR, Lachal J. The New HPV Vaccination Policy in France. N Engl J Med. 2018;378(12):1160. doi: 10.1056/NEJMc1801036 29562152

16. NKCx. The Swedish National Cervical Screening Register Annual Report, Stockholm, Sweden, 2018. [cited 2019 Sep 8]. Available from:

17. Arbyn M, Smith SB, Temin S, Sultana F, Castle P; Collaboration on Self-Sampling and HPV Testing. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018;363:k4823. doi: 10.1136/bmj.k4823 30518635

18. Palmer TJ, McFadden M, Pollock KG, Kavanagh K, Cuschieri K, Cruickshank M, et al. HPV immunisation and cervical screening—confirmation of changed performance of cytology as a screening test in immunised women: a retrospective population-based cohort study. Br J Cancer. 2016;114(5):582–9. doi: 10.1038/bjc.2015.474 26931370

19. Sultana F, Winch K, Saville M, Brotherton JML. Is the positive predictive value of high-grade cytology in predicting high-grade cervical disease falling due to HPV vaccination? Int J Cancer. 2019;144(12):2964–2971. doi: 10.1002/ijc.32050 30536935

20. Ronco G, Dillner J, Elfström KM, Tunesi S, Snijders PJ, Arbyn M, et al; International HPV screening working group. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383(9916):524–32. doi: 10.1016/S0140-6736(13)62218-7 24192252

21. Jeronimo J, Holme F, Slavkovsky R, Camel C. Implementation of HPV testing in Latin America. J Clin Virol. 2016;76 Suppl 1:S69–S73. Epub 2015 Nov 28. doi: 10.1016/j.jcv.2015.11.035 26699418

22. Binagwaho A, Wagner CM, Gatera M, Karema C, Nutt CT, Ngabo F. Achieving high coverage in Rwanda's national human papillomavirus vaccination programme. Bulletin of the World Health Organization 2012;90:623–628. doi: 10.2471/BLT.11.097253 22893746

23. Dorji T, Tshomo U, Phuntsho S, Tamang TD, Tshokey T, Baussano I, et al. Introduction of a National HPV vaccination program into Bhutan. Vaccine. 2015;33(31):3726–30. doi: 10.1016/j.vaccine.2015.05.078 26057136

24. Gavi, the Vaccine Alliance. Review of Gavi Support for HPV vaccine. 2017. [cited 2019 Sep 24]. Available from:

Článek vyšel v časopise

PLOS Medicine

2020 Číslo 1

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…

Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.


Nemáte účet?  Registrujte se