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Meta-Analysis
. 2022 Jul 15;101(28):e29329.
doi: 10.1097/MD.0000000000029329.

Association of human papillomavirus vaccination with cervical cancer screening: A systematic review and meta-analysis

Paddy Ssentongo  1   2 , Jennifer S McCall-Hosenfeld  1   3 , William A Calo  1 , Jennifer Moss  4 , Eugene J Lengerich  1 , Vernon M Chinchilli  1 , Djibril M Ba  1
Affiliations
Meta-Analysis

Association of human papillomavirus vaccination with cervical cancer screening: A systematic review and meta-analysis

Paddy Ssentongo et al. Medicine (Baltimore). .

Abstract

Introduction: Prophylactic vaccination and routine screening are effective at preventing most cases of cervical cancer. Globally, cervical cancer is the fourth most frequently diagnosed cancer among women. The aim of this study was to investigate the association between human papillomavirus virus (HPV) vaccination (1, 2, or 3 doses) and cervical cancer screening.

Methods: PubMed (MEDLINE), Scopus, Web of Science, and Cochrane Library electronic databases were systematically searched from July 1, 2006, up to September 30, 2021. We pooled estimates using random-effects models. Heterogeneity between studies was quantified using Cochran Q test and I2 statistics. In total, 12 studies involving 2.4 million individuals were included in the meta-analysis.

Results: In the adjusted estimates, uptake of HPV vaccination was associated with increased cervical cancer screening (pooled relative risk [RR]: 1.35; 95% confidence interval [CI]: 1.21, 1.50; n = 12). Between-study heterogeneity was large (I2 = 99%). Compared to unvaccinated, those who received 3 doses of HPV vaccine had the highest uptake of cervical cancer screening (RR: 1.85; 95% CI: 1.58, 2.17), followed by those who received 2 doses (RR: 1.34; 95% CI: 1.21, 1.47). No statistically significant association with screening was found for those who received a single dose of the HPV vaccine.

Conclusion: In this meta-analysis, uptake of HPV vaccination was associated with higher cervical cancer screening. It is plausible that vaccinated individuals are more likely to engage in preventive health behaviors. Healthcare providers should remind patients to continue with routine screening for cervical cancer regardless of their HPV vaccine status since vaccination does not protect against all HPV types.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Forest plot of the overall pooled adjusted effect estimate.
Figure 2.
Figure 2.
Forest plot of studies stratified by HPV vaccine doses. HPV = human papillomavirus virus.
Figure 3.
Figure 3.
Forest plot of studies stratified by WHO regions. WHO = World Health Organization.
Figure 4.
Figure 4.
Forest plot of studies stratified by quality score.
See this image and copyright information in PMC

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