The most cost-effective strategy for human papillomavirus (HPV) vaccination and screening would initiate vaccinations at age 12, followed by cytology screening for HPV every 3 years beginning at age 25, according to the results of a new computer-based modeling study. This approach would reduce mortality due to cervical cancer by 94 percent compared with no intervention at all, concluded the study's authors, Dr. Sue J. Goldie from the Harvard School of Public Health and colleagues, in the April 21 Journal of the National Cancer Institute.

In the study, the cost-effectiveness of various vaccination strategies for two of the most oncogenic HPV strains (16 and 18) and screening - alone and in combination - were examined. All vaccinations were begun at 12 years of age; screenings began at 18, 21, 25, 30, or 35 years of age, with screening intervals ranging from 1 to 5 years. The researchers modeled varying effectiveness of the vaccines ranging from 70 percent to 100 percent. The next most cost-effective strategy, which resulted in an 89.7 percent reduction in mortality, involved a combination of vaccination with screening every 5 years beginning at age 21.

Vaccination at 12 years of age would allow for a later age of screening initiation and less frequent screening intervals than are currently recommended, the authors concluded. Under current U.S. Preventive Services Task Force recommendations, a woman should begin cervical cancer screening 3 years after she begins having sexual intercourse, but no later than age 21; subsequently women should be screened at least once every 3 years.  Read more  



A Model for Addressing Health Care Disparities

In late March, the trans-HHS Cancer Health Disparities Progress Review Group (PRG) released its report, Making Cancer Health Disparities History. The report includes recommendations to the U.S. Department of Health and Human Services (HHS) intended to significantly reduce cancer health disparities in the United States.

Last week I had the honor of officially presenting the PRG's final report to the recently formed HHS Health Disparities Council. The council, which is charged with establishing a coordinated, HHS-wide approach to battling health care disparities, will review the report and decide which recommendations can and should be pursued.  Read more  

This NCI Cancer Bulletin is produced by the National Cancer Institute (NCI). NCI, which was established in 1937, leads a national effort to eliminate the suffering and death due to cancer. Through basic and clinical biomedical research and training, NCI conducts and supports research that will lead to a future in which we can prevent cancer before it starts, identify cancers that do develop at the earliest stage, eliminate cancers through innovative treatment interventions, and biologically control those cancers that we cannot eliminate so they become manageable, chronic diseases. For more information on cancer, call 1-800-4-CANCER or visit http://cancer.gov. NCI Cancer Bulletin staff can be reached at ncicancerbulletin@mail.nih.gov.