Eurogin 2016 Roadmap: how HPV knowledge is changing screening practice.

Area of Science:

• Oncology
• Virology
• Public Health

Background:

• Human papillomaviruses (HPVs) are the primary cause of cervical cancers and other anogenital and oropharyngeal cancers.
• Advances in understanding HPV have driven the development of effective prevention strategies, including vaccination and screening.
• HPV vaccines have demonstrated significant reductions in HPV infections and precancerous lesions in highly vaccinated populations.

Purpose of the Study:

• To evaluate the evolving role of HPV knowledge in clinical practice for infection and disease control.
• To review cervical and anal cancer screening strategies in the context of widespread HPV vaccination.
• To discuss the implementation of HPV-based screening in various healthcare systems, particularly in high-income countries.

Main Methods:

• Review of current evidence on HPV vaccination and screening efficacy.
• Analysis of healthcare system approaches to HPV-based screening.
• Examination of anal cancer screening considerations for high-risk populations, such as HIV-infected men who have sex with men.

Main Results:

• HPV vaccination has successfully reduced HPV infections and early cancer precursors in vaccinated populations.
• Cervical cancer screening remains crucial for many decades, with primary HPV screening showing higher sensitivity for precancers.
• While population-based screening for other anogenital cancers is not feasible, targeted anal cancer screening may be warranted for specific high-incidence groups.

Conclusions:

• HPV vaccines are highly effective but do not eliminate the need for continued cervical cancer screening.
• Transitioning to primary HPV screening is a viable strategy for improving cervical cancer detection and potentially extending screening intervals.
• Further research is needed to address evidence gaps in HPV-based prevention and screening for anal cancers, especially in at-risk populations.