Prevention of cervical cancer through HPV vaccination
and HPV screening
Human papillomaviruses (HPV) play a causal role in the
genesis of virtually all cancers of the uterine cervix. Most
HPV infections regress spontaneously, progression to invasive
cancer occurs only in the minority of infections with
a minimal latency period of eight years and an average
interval of 15 to 30 years. The HPV dependant genesis offers
best chances to prevent cervical cancer either primarily
with vaccines or secondarily with HPV screening.
The quadrivalent prophylactic HPV 6/11/16/18 as well as
the bivalent HPV 16/18 vaccine are safe and efficient. Vaccinated
individuals are almost completely protected from
persistent infections with the HPV-types included in the
vaccine. Because of some cross protection from related
HPV types an overall 70 % to 80 % protection from highgrade
cervical neoplasia can be expected. It seems that vaccine
protection will be maintained for more than 20 years.
The best efficiency of HPV vaccination is observed in girls
prior to sexual debut.
A negative HPV test excludes almost any risk for the
development of invasive cancer for more than 6 years.
Primary HPV screening of women aged 30 years or older
was significantly more efficient in detecting in CIN3 and
preventing cervical cancer than cytology in meta-analyses
of randomized controlled trials (RCTs). A first German
primary HPV screening project was started in Wolfsburg
2006 and confirmed that the benefits observed in RCTs
can be transferred in daily routine.
Combining HPV vaccination and HPV screening seems to
be a promising way to eradicate cervical cancer.
CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol
2012; 8(2): 162–175
Human papillomavirus (HPV), primary HPV screening,
vaccination, cervical intraepithelial neoplasia (CIN),
Karl Ulrich Petry
Klinikum der Stadt Wolfsburg, Klinik für Frauenheilkunde,
Geburtshilfe und Gynäkologische Onkologie, Wolfsburg
Reviewer: Eva Werner, Schwerin,
und Michael Wojcinski, Bielefeld
Petry K. U. Prävention ... Gynakol Geburtsmed Gynakol Endokrinol 2012; 8(2): 162–175 publiziert 31.07.2012 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2012 ISSN 1614-8533