Long-term incidence trends of HPV-related cancers, and cases preventable by HPV vaccination: a registry-based study in Norway
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    Comment on: "Long-term incidence trends on HPV-related cancers, and cases preventable by HPV vaccination: a registry-based study in Norway "
    • Malene Skorstengaard, MD, PhD-student University of Copenhagen, Denmark
    • Other Contributors:
      • Lise Thamsborg, MD, PhD-student
      • Elsebeth Lynge, Professor

    Dear Editor,

    We have with great interest read the article by Hansen et al. (1). We have though two comments for reflection. First, the authors state that the stable incidence of cervical cancer indicates “apparent exhaustion of the cancer-reducing potential of current cervical screening”. Given that the coverage by examination can be increased with e.g. self-sampling (2), that the follow-up of abnormal findings is still suboptimal (3), and that Norway among other countries plans implementation of HPV-based screening (4) which provides better protection than cytology-based screening (5), we find the authors’ statement to be a bit too pessimistic especially for the many birth cohorts of women who still have to rely on screening for their primary protection against cervical cancer.

    Second, the authors divide the HPV-vaccine preventable cancers into cervical squamous cell carcinomas and other cancers, and they argue - based on increasing trends - that the HPV vaccine can prevent a “substantial” number of these other cancers in both women and men. It should, however, be taken into account that the incidence of these cancers is low despite increasing trends. Out of 32,000 new cancer cases in Norway in 2016 (6), 271, 0.8%, fell into the other HPV-vaccine preventable category. The additional potential for prevention of cervical cancer is actually greater. With 3205 treatments per year for cervical intraepithelial neoplasia (3), the HPV-vaccine could prevent an addi...

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    Conflict of Interest:
    None declared.