Evaluating Strategies to Accelerate Cervical Cancer Elimination

CHDS researchers Allison Portnoy, Jane Kim, and Emily Burger evaluated vaccination and screening strategies to accelerate elimination of cervical cancer in Norway. In order to accelerate progress towards the World Health Organization goal of cervical cancer elimination, organizations and societies in Norway have called for intensified human papillomavirus (HPV) vaccination strategies, such as offering vaccination up to age 30 years. The CHDS team used simulation modeling to evaluate the effect of proposed vaccination strategies on the cervical cancer elimination timeline. They also examined improvements to screening adherence with and without intensifying vaccination.

The researchers found that proposed strategies of intensified vaccination are unlikely to accelerate cervical cancer elimination in Norway but may reduce population-level cervical cancer incidence compared to current cervical cancer control efforts. Importantly, justification for intensifying vaccination has presumed that this would allow for simultaneously de-intensifying the frequency of cervical cancer screening efforts. However, CHDS researchers found that none of the analyzed strategies could achieve the goal of both de-intensifying screening and accelerating the timeline for cervical cancer elimination.

Improved screening adherence among under-screened and never-screened women may both eliminate cervical cancer on a faster timeline and lead to greater health benefits, however, compared with the vaccination-only interventions modeled. The research found that increases in screening adherence achieved the greatest health impact in the long term and will likely be the approach that impacts the elimination timeframe in countries such as Norway. Importantly, improving screening adherence among women who screen infrequently could target women who have already acquired their causal HPV infection, and at ages where the burden of cervical cancer is greatest.

Learn more: Read the article, Vaccination and Screening Strategies to Accelerate Cervical Cancer Elimination in Norway: A Model-Based Analysis
Learn more: Related CHDS resource, New Microsimulation Models to Inform Cervical Cancer Control
Learn more: Related press release, HPV Vaccines for Adults over Age 26 May Not Be Cost-Effective