Optimising cervical screening in the HPV vaccination era

The entry into the cervical screening programme of women who have been vaccinated against HPV will impact on screening effectiveness and, hence, cost-effectiveness. Vaccinated women have a much lower risk of having cervical intra-epithelial neoplasia, and this will affect the performance of the screening test and other investigations. It is likely that new screening protocols will need to be developed (for example, based on primary HPV screening, or less frequent screening, or starting screening at an older age). The challenge for decision-makers and service providers is to decide how screening should be organised for maximum effectiveness and cost-effectiveness in the “HPV vaccination era”.

This workpackage has two main objectives: (1) to ascertain the likely impact of HPV vaccination on current cervical screening protocols and (2) to investigate the effectiveness and cost-effectiveness of alternative screening scenarios in the “HPV vaccination era”.

To achieve this CERVIVA will, in conjunction with key stakeholders: identify a set of plausible and feasible alternative screening scenarios; assess available mathematical and economic models; and identify and parameterise the model most suitable for the Irish setting. This model will then be used to estimate the impact of HPV vaccination on current screening practice, the likely changes over time as more of the screening population are vaccinated, and to make recommendations on the most effective and cost-effective screening options.