Prospects for a prophylactic HPV vaccine: rationale and future implications for cervical cancer screening

Cytologic screening in combination with ablative therapy has helped reduce cervical cancer mortality in the developed world. Despite the success of this approach, cervical cancer remains a major cause of death, especially among women with limited access to health care. Recognition that human papillomaviruses (HPVs) are the main etiologic agent in cervical cancer suggests that a prophylactic vaccine could reduce the incidence of HPV infection and, therefore, achieve cancer control with reduced reliance on costly screening programs. In this review, the rationale for developing a prophylactic HPV vaccine and the potential impact that vaccination would have on cervical cancer screening are discussed.