Scottish cervical cancer prevention programme: assessing and modelling the impact of HPV 16/18 immunisation on the performance of current cervical screening and the effectiveness of alternative cervical screening strategies to optimise cancer prevention in the HPV immunisation era
In Scotland, human papilloma virus (HPV) vaccination of females aged 12 to 13 years started, via a school immunisation programme, on 1 September 2008. A ‘catch-up campaign’, targeting females up to the age of 18, ran alongside this. Scotland now moves from the Scottish Cervical Screening Programme to a Scottish Cervical Cancer Prevention Programme, with the aim of further reducing cervical cancer mortality by primary prevention based on HPV immunisation and secondary prevention based on screening. Health Protection Scotland (HPS) is coordinating the introduction of the new immunisation programme, and also established an HPV immunisation project to monitor its impact. Many new questions need to be investigated to inform NHS policy on the future delivery of the combined screening and immunisation programme. Scotland is in a unique position to lead on new research as 16–17-year-olds were immunised in 2008 and become eligible for cervical screening from September 2010. Our research combined routinely collected data on screening and disease detection with data on HPV genotyping and screening test performance to model future screening performance.
Outcome and Translation
This study will inform NHS Scotland policy on future service delivery of the national cervical screening and immunisation programme. Scotland’s research networks and HPS can collaborate effectively using Scotland’s excellent data linkage facilities to further develop and deliver a composite population health intervention for cancer prevention, and improve health outcomes in Scotland.
HERU researchers involved in this research project: Aileen Neilson
External collaborators: M Cruickshank (Department of Obstetrics and Gynaecology, University of Aberdeen); C Campbell, D Weller (University of Edinburgh); Y Choi (Health Protection Agency); H Cubie (Lothian University NHS Hospital Trust, Royal Infirmary of Edinburgh); K Cuschieri (Edinburgh Royal Infirmary); M Donaghy, C Robertson (Health Protection Scotland); J Imrie (Monklands District General Hospital) and F Sullivan (University of Dundee)
Cruickshank, M., Campbell, C., Choi, Y., Cubie, H., Cuschieri, K., Donaghy, M., Robertson, C., Smart, L., Sullivan, F. and Weller, D. (Neilson, A.R. is on the project team and contributed to Appendix 3 (2016) The Scottish Cervical Cancer Prevention Programme: assessing and modelling the impact of HPV 16/18 immunisation on the performance of current cervical screening performance and the effectiveness of alternative cervical screening strategies to optimise cancer prevention in the HPV immunisation era. Final report submitted to the Chief Scientist Office (CZG/4/528).
Kavanagh, K., Neilson, A.R., Cruickshank, M., Cotton, S. and Robertson, C. (2016) 'Clinical and economic impact of alternative screening policies in the post HPV vaccination in Scotland' [Poster], British Society for Colposcopy and Cervical Pathology, Annual Scientific Meeting, Life Science Events, Bradford, England, 13-15 April 2016.
Neilson, A.R. (2016) 'Clinical and economic impact of alternative screening policies in the post HPV vaccination era in Scotland', Obstetrics and Gynaecology Postgraduate Seminar Series, Aberdeen Maternity Hospital, Aberdeen, 25 May 2016.
Kavanagh, K., Neilson, A. R., Cruickshank, M., Cotton, S. and Robertson, C. (2016) 'Modelling the impact of vaccination on alternative screening policies in Scotland', European Research Organisation on Genital Infection and Neoplasia (EUROGIN) 2016, Salzburg, Austria, 15-18 June 2016.