Published 28 July 2008, doi:10.1136/bmj.a1049
Cite this as: BMJ 2008;337:a1049

Letters

Human papillomavirus vaccination

Paradox of vaccination in cervical cancer and screening

The first 150 words of the full text of this article appear below.

The development of human papillomavirus (HPV) vaccines and their potential for reducing cervical cancer incidence and mortality is generally considered an important step to improve population health worldwide. For countries without well performing cervical cancer screening programmes and lack of treatment options the current epidemiological and economic models seem applicable.

However, the assumptions underlying published economic evaluations in countries with high coverage, well functioning screening programmes, such as that by Jit et al from the United Kingdom,1 neglect an important limitation to the validity of their models. There is a non-negligible risk that a high HPV vaccine coverage in adolescents will lead to a decrease in screening uptake in later years because vaccinated women will see themselves as no longer at risk and will consequently avoid the unpleasant screening procedure.

As about 30% of cervical cancers are not caused by the current HPV vaccines against HPV types 16 and 18, . . . [Full text of this article]

Christian A Gericke, professor of public health policy1

1 University of Adelaide, Adelaide, SA 5005, Australia

christian.gericke@adelaide.edu.au


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Relevant Article

Economic evaluation of human papillomavirus vaccination in the United Kingdom
Mark Jit, Yoon Hong Choi, and W John Edmunds
BMJ 2008 337: a769. [Abstract] [Full Text] [PDF]

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