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ASCO issues global guidance on HPV vaccination to prevent cervical cancer

The American Society of Clinical Oncology, or ASCO, has released the first guideline on primary prevention of cervical cancer that accommodates multiple regions of the world and their varied socioeconomic and structural resources.

“Although HPV vaccine has been around for more than a decade, the uptake of the vaccine has been less than ideal in many places, including in high-resource countries such as the United States," Silvina Arrossi, PhD, a researcher at Instituto Nacional del Cancer in Buenos Aires, Argentina, and co-chair of the panel that developed the guidelines, said in a press release. “As an organization of cancer doctors, the ASCO continues to endorse HPV vaccination programs and efforts to help spare more women around the world from this very difficult cancer.”

The guideline, published in the Journal of Global Oncology, includes recommendations based on four levels of resource settings — basic, limited, enhanced and maximal. According to ASCO:

• In all resource settings, two doses of HPV vaccine are recommended for girls aged 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months, and girls who are HIV–positive should receive three doses.
• In maximal and enhanced settings, girls aged 15 years and older who received their first dose before that age may complete the series, but if no doses were received before age 15 years, three doses should be administered, and in both scenarios, the patient can receive vaccination through age 26 years.
• In limited and basic settings, and if sufficient resources remain after vaccinating girls aged 9 to 14 years, girls who received one dose may receive additional doses from age 15 to 26 years.
• In maximal, enhanced and limited settings, boys may be vaccinated to prevent other noncervical HPV–related cancers and diseases if there is 50% or greater coverage in the priority female target population, there are sufficient resources and it is cost-effective to do so.
• In basic settings, vaccinating boys is not recommended.

Arrossi and colleagues said the guideline, which was developed after a thorough review of the literature on the subject from 1966 to 2015, complements ASCOs two other global, resource-stratified guidelines on cervical cancer and reinforces certain components of the HPV guidelines established by WHO, CDC, and guideline-issuing authorities in Canada, Germany and Australia.  

“Because resource availability varies widely, both among and within countries, we need to adjust strategies to improve access to HPV vaccination everywhere," Silvia de Sanjosé, MD, PhD, head of the cancer epidemiology research program at Institut Català d'Oncologia in Barcelona, Spain, and co-chair of the panel that developed the guideline, said in the release. “This guideline is unique in offering cervical cancer vaccination recommendations that can be adapted to different resource levels, and we expect it to have a major impact on the global health community." – by Janel Miller

Disclosures: Arrossi reports no relevant financial disclosures. Sanjosé reports receiving funding from Merck and GlaxoSmithKline. Please see the study for a full list of the other authors’ relevant financial disclosures.