# Offer HPV vaccination to women when they come for cervical screening or treatment

Source: https://onco.cc/ideas/idea-prev-hpv-vaccinate-at-screening/  
OnCo record `idea-prev-hpv-vaccinate-at-screening` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adult women who missed the vaccine could get it at their screening visit. Vaccination around treatment for precancer also seems to cut recurrence.

## Summary

Observational data and the NOVEL trial suggest HPV vaccination at the time of excisional treatment for CIN2+ reduces recurrence. Propose a screen-and-vaccinate offer for women aged 25-45 at screening, with an RCT of recurrence in treated women and cost-effectiveness modelling for the screened population.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Vaccination at CIN treatment reduces CIN2+ recurrence by at least half, and vaccination at screening reduces incident HPV16/18 infection by at least 40% in unvaccinated 25-45-year-olds.
- Rationale: Prevents reinfection and uses an existing clinical contact.
- Proposed test: 1,500-woman RCT in treated women; pragmatic uptake pilot in screening clinics.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Prevention we already have is not deployed): Islami et al., Proportion of cancer attributable to modifiable risk factors (CA 2018): https://doi.org/10.3322/caac.21440

## Connected records

- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/)
- fronts: [Prevention & Risk](https://onco.cc/fronts/prevention/)
- technologies: [HPV & HBV vaccination](https://onco.cc/technologies/hpv-vaccine/)
- bottlenecks: [Prevention we already have is not deployed](https://onco.cc/bottlenecks/b-prevention-adoption/)
- key papers: [England's HPV programme: cervical cancer down 87% in the first cohort vaccinated at 12-13](https://onco.cc/key-papers/paper-hpv-vaccine-england-lancet-2021/), [Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States](https://onco.cc/key-papers/paper-islami-ca-cancer-j-clin/)

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