Cervical cancer screening behaviors differ between vaccinated and unvaccinated women

Women vaccinated against the human papillomavirus (HPV) are more likely to be screened for cervical cancer than women who have not been vaccinated, according to a new study from the Penn State College of Medicine. HPV is the most common sexually transmitted infection in the United States, according to the Centers for Disease Control and Prevention. There are over 140 strains of HPV, and infections often go away without medical treatment. However, some high-risk strains can lead to serious health problems, such as genital warts and cervical cancer.

Although there is no cure for HPV, routine cancer screenings and HPV vaccinations have been shown to reduce rates of cervical cancer. Multi-dose HPV vaccines -; such as Gardasil and Cervarix -; were introduced in the early 2000s for male and female patients, aged 9 to 26. Data from the CDC shows that these vaccines can prevent more than 90% of HPV-related cancers, as well as protect against precancerous cells.

Our results underscore the importance of routine and continuous screening for cervical cancer, regardless of a person’s HPV vaccination status. “

Djibril Ba, principal investigator

Research Data Management Specialist in the Department of Public Health Sciences. “More studies are needed to better understand cervical cancer screening behaviors in the age of vaccines.”

HPV vaccine dosing schedules vary depending on the age of patients. Patients between the ages of 9 and 26 may need two or three doses of an HPV vaccine to be fully immunized.

Investigators looked at data from nearly one million privately insured American women -; 21 to 26 years old -; to examine factors associated with cervical cancer screenings from 2006 to 2016. The team assessed a range of factors, such as a patient’s HPV vaccination status, medical history, mental health , lifestyle choices and geographic location, to see how these affected cervical cancer screenings.

The results reveal that cancer screening behaviors differ between vaccinated and unvaccinated women. The investigators found that among the study population, about 20% of individuals were vaccinated against HPV. Of those who were vaccinated, 44.9% received a single dose of the HPV vaccine, while 28.3% received two doses and 26.8% received three doses.

According to the study, women who received at least one dose of the HPV vaccine were 34% more likely to be screened for cervical cancer than those who were not vaccinated. The researchers found that the cancer screening rate increased as the dose of the HPV vaccination increased and fully vaccinated individuals were more likely to be screened. The study also found that cancer screening rates were generally declining over that 10-year period. Overall, the results show that 49.8% of women were screened for cervical cancer.

Additionally, the researchers found that vaccinated individuals had higher levels of health care use prior to receiving the HPV vaccine compared to their unvaccinated counterparts. Based on these results, investigators said that increased access to care and information on prevention services could result in more patients receiving the HPV vaccine and / or undergoing testing. cancer.

The research team also found geographic differences. The vast majority of patients lived in urban areas. The results revealed that women living in the South had the highest cervical cancer screening rates, while those living in the western states had the lowest screening rates.

Insurance coverage can also influence whether or not women receive prevention services. According to the study, people with high-deductible insurance plans had lower cervical cancer screening rates than women with other medical coverage.

“Our results strongly suggest that access to and use of different types of preventive health services, in this case vaccination and cancer screening, go hand in hand,” said researcher Dr Jennifer McCall-Hosenfeld, professor. associate, departments of medicine. and Public Health Sciences. “Tackle the obstacles to receiving preventive health services – whether informational, financial, cultural or logistical -; is essential for reducing the burden of preventable disease. Vaccines are at the heart of the public health mission. “

The researchers said completing the HPV vaccination schedule could have helped patients adhere to routine cervical cancer screenings. Based on these results, healthcare providers should educate patients about the effectiveness of the HPV vaccine in preventing cancer and stress the importance of routine screenings, such as Pap tests. Screenings can help detect and treat related health problems.

The researchers noted some limitations that could be addressed in future studies. The study population was limited to patients with commercial and private health insurance and may not be generalizable to populations not insured by the private sector. Researchers were only able to capture the HPV vaccination status of people who received their vaccines after registering in the MarketScan database.

Penn State researchers Paddy Ssentongo, Vernon Chinchilli, Edeanya Agbese, Guodong Liu, and Douglas Leslie contributed to this research. Ping Du of Takeda Pharmaceutical Company also contributed to this study.


Pennsylvania State College of Medicine

Journal reference:

Bad., et al. (2021) Cervical cancer screening varies by HPV vaccination status among a national cohort of young women privately insured in the United States from 2006 to 2016. Medication. doi.org/10.1097/MD.0000000000027457.

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