Background
The incidence of invasive cervical cancer in Germany has been greatly decreased due to cytological screening. For a further reduction it seems to be primarily meaningful to achieve a higher participation rate, which is now on the political agenda. This could be realized through an organized screening program. On reaching the age for screening, the rate of cervical intraepithelial neoplasia (CIN) is reduced in the generations who received human papillomavirus (HPV) vaccination, which leads to a reduced positive predictive value and increased rate of false positives in cytology.
Discussion
An implementation of HPV testing in primary screening, as is currently the case in most western countries, is expected to lead to further improvements. The therapy of CIN is associated with pregnancy complications and should be carried out only when indicated after adequate diagnostic measures, such as colposcopy with biopsy. The new nonavalent HPV vaccine which expected to be released in 2016 may lead to a big step forward in vaccination effectiveness.
Conclusion
If the results of recent vaccination studies can be confirmed and high vaccination rates can be achieved, this vaccine has the potential to portend the beginning of the end for some gynecological diseases, such as cervical cancer, vaginal cancer and condylomata acuminata.