Preventing cervical cancer through human papillomavirus vaccination and cervical screening programmes

Cervical cancer causes more than 300,000 deaths worldwide every year, affecting women from a young age. It has a well-understood natural history, caused by HPV, which is estimated to be responsible for 99.8% of cases. In order to decrease the number of UK cervical cancer cases, a national screening programme was launched in 1988. Women between the ages of 25 and 64 are invited for cervical screening. A primary high-risk HPV testing approach is used, whereby samples are only tested for cytology if they are positive for high-risk HPV. The national HPV vaccination programme was introduced in 2008 in the UK. The Gardasil 9 vaccine is offered at year 8 in UK schools (ages 12–13 years old) to boys and girls. These programmes have been a huge success in reducing the number of cervical cancer cases. However, still only 70% of eligible women attend their screening appointments. To further increase the proportion of women reached by the programme, further alternatives are currently tested, including home vaginal swab tests and urinary HPV testing.