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CERVICAL CANCER - PREVENTION & SCREENING
Mortality due to cervical cancer can be reduced by prevention, early detection & treatment.
Vaccination may be started as early as 9 years old.
Vaccination may reduce the incidence of HPV-related disease.
Screening for cervical cancer after vaccination is still recommended because only 70% of the virus types associated w/ invasive cervical cancer consist of HPV 16 & 18 types & women may not be entirely protected if they have been infected w/ other HPV types prior to vaccination.

Introduction

Routine Vaccination

  • Females, 11-12 years of age, are recommended to receive 2 doses of human papilloma virus (HPV) vaccine 6-12 months apart
    • Vaccination may be started as early as 9 years old
  • World Health Organization (WHO) recommends a 2-dose vaccination schedule with a minimum interval of 6 months between doses for females <15 years old
    • For females ≥15 years old and immunocompromised individuals, the 3-dose vaccination schedule is recommended

Catch-Up Dose

  • Females, 13-26 years of age, who have not been previously vaccinated or those who have not completed the doses
    • Those who have not received any previous HPV vaccination should receive a 3-dose vaccine series  
    • Those who have received 2 doses of HPV vaccine at least 5 months apart before the age of 15 years are adequately vaccinated and do not need any additional HPV vaccine dose
    • Those who have received only 1 dose or 2 doses <5 months apart before the age of 15 years are not adequately vaccinated and must receive an additional HPV vaccine dose 
  • HPV exposure risks should be discussed with females 18-45 years old
    • Vaccination would provide full benefit to sexually active females who have not been infected by HPV
    • Less benefit is provided to sexually active females who have been infected by one or more HPV types
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