Concomitant Human Papillomavirus (HPV) Vaccination and HPV Screening for Rapid Elimination of HPV Infection and Cervical Cancer

Abstract We describe a nationwide implementation trial of concomitant Human Papillomavirus (HPV) vaccination and HPV screening of young women to reduce the incidence of HPV and provide HPV screening-mediated protection against cervical cancer. All 89,547 women born 1994-1999 resident in the capital region of Sweden were personally invited to concomitant vaccination and screening with 26,125 women (29,2%) enrolling. HPV genotyping found a strong decline of HPV16 and 18 in birth cohorts previously offered vaccination, but no decline for HPV types not targeted by vaccines. Our dynamic transmission modelling predicted that the trial could reduce the incidence of high-risk HPV infections among the 1994-1998 cohorts by 64-69% in 3 years. At baseline, we demonstrated feasibility, validated transmission model projections, and obtained power estimates. At follow-up, the trial can estimate HPV incidence reductions of +/-0.1% with 99.9% confidence. Clinicaltrials.gov identifier: NCT04910802.