The HPV prevention and control program in Poland: progress and the way forward

Abstract

This review assesses Poland's activities in preventing and managing human papillomavirus (HPV)-related diseases, summarizing information from the 2023 HPV Prevention and Control Board meeting. Progress in primary, secondary, and tertiary prevention identifies opportunities to strengthen control of cervical cancer. Poland's national HPV vaccination program, launched in June 2023, initially achieved suboptimal coverage. In contrast, regional initiatives such as the Wrocław immunization program, which has operated for over a decade, demonstrate highly relevant context-specific best practices, including the use of a "train the trainers" model to effectively share information among stakeholders and mitigate crisis. Improved vaccination rates require not only ease of access to vaccines, as the COVID-19 vaccination program has demonstrated, but also addressing parental concerns about vaccine safety and effectiveness. Moreover, innovative strategies-such as integration of adolescent vaccination with cervical screening among women 30 to 45 years old-may have the potential to increase uptake and accelerate elimination in the country. For secondary prevention, Poland is well placed to switch to HPV-based screening, having a centralized registry, validated tests, and standardized colposcopy. The results of a study of the "HPV testing In Polish POpulation" (HIPPO) cervical cancer screening program confirm the superiority of HPV testing over cytology; however, current opportunistic screening poses challenges concerning completeness and equity in data. Expanding organized screening programs and midwife-led services will increase access and help build confidence in public-sector health systems. Tertiary prevention is in line with updated European guidelines. In early-stage cervical cancer, there has been an increase in the use of less invasive surgical approaches, and immunotherapies, such as pembrolizumab, hold promise in locally advanced disease. Initial data suggest that HPV vaccination may help reduce the incidence of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) after excisional treatments, but more data are needed. Poland's coordinated approach shows significant improvements while also highlighting the need for continued innovation, quality control, and public engagement to improve the prevention and treatment of HPV-related conditions.