Controlled Trial of Cervical Cancer Screening Frequency Among Human Papillomavirus Vaccinated Women II : Cervical Pre‐Cancer End‐Points by Specific Non‐Vaccine HPV Types

ABSTRACT We conducted a controlled trial among 5626 early adolescent women vaccinated in 2007–2009 against human papillomavirus (HPV) types 16/18 to evaluate the impact of high‐intensity versus low‐intensity cervical screening, respectively at ages 22/25/28 and 28 years with squamous‐cell intraepithelial lesions (SILs) as the end‐point. Over the 16‐year follow‐up, most of the cytologically and/or histologically confirmed low‐grade and high‐grade SILs were associated with non‐vaccine‐targeted, medium oncogenicity HPV types 33/35/52/58 belonging to clade A9. The low‐intensity cervical screening was non‐inferior to the high‐intensity screening in the identification of these lesions. Possibly, the transition from cervical infections with vaccine‐covered HPV types to infections with non‐vaccine‐covered HPV types contributes to more manageable occurrence of the screen‐detected cervical lesions. Reduction of cervical screening among vaccinated women to a minimum may be warranted to balance the harm—benefit ratio of screening.