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Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation.
Literature Information
| DOI | 10.3322/caac.21616 |
|---|---|
| PMID | 32639044 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2020 |
| Times Cited | 76 |
| Keywords | cancer prevention, human papillomavirus (HPV), immunization, vaccine |
| Literature Type | Journal Article, Practice Guideline |
| ISSN | 0007-9235 |
| Pages | 274-280 |
| Issue | 70(4) |
| Authors | Debbie Saslow, Kimberly S Andrews, Deana Manassaram-Baptiste, Robert A Smith, Elizabeth T H Fontham |
TL;DR
The American Cancer Society (ACS) recommends routine HPV vaccination for children aged 9 to 12 years to enhance vaccination rates and prevent more cancers, urging healthcare providers to initiate vaccination at ages 9 or 10. Additionally, while catch-up vaccination is advised for individuals up to age 26, the ACS does not support HPV vaccination recommendations for adults aged 27 to 45 due to limited effectiveness and unclear benefits.
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cancer prevention · human papillomavirus (HPV) · immunization · vaccine
Abstract
The American Cancer Society (ACS) presents an adaptation of the current Advisory Committee on Immunization Practices recommendations for human papillomavirus (HPV) vaccination. The ACS recommends routine HPV vaccination between ages 9 and 12 years to achieve higher on-time vaccination rates, which will lead to increased numbers of cancers prevented. Health care providers are encouraged to start offering the HPV vaccine series at age 9 or 10 years. Catch-up HPV vaccination is recommended for all persons through age 26 years who are not adequately vaccinated. Providers should inform individuals aged 22 to 26 years who have not been previously vaccinated or who have not completed the series that vaccination at older ages is less effective in lowering cancer risk. Catch-up HPV vaccination is not recommended for adults aged older than 26 years. The ACS does not endorse the 2019 Advisory Committee on Immunization Practices recommendation for shared clinical decision making for some adults aged 27 through 45 years who are not adequately vaccinated because of the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision making on patients and clinicians, and the lack of sufficient guidance on the selection of individuals who might benefit.
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Primary Questions Addressed
- What are the key differences between the 2020 ACS HPV vaccination guidelines and previous recommendations?
- How does the ACS guideline adaptation impact the vaccination rates among different age groups?
- What evidence supports the recommendation against catch-up HPV vaccination for adults over 26 years?
- How can healthcare providers effectively communicate the importance of early HPV vaccination to parents and guardians?
- What are the potential barriers to achieving higher on-time vaccination rates as suggested by the ACS guidelines?
Key Findings
Key Insights
Research Background and Objective: The American Cancer Society (ACS) has adapted the existing guidelines from the Advisory Committee on Immunization Practices regarding human papillomavirus (HPV) vaccination. The primary goal of this update is to enhance the vaccination coverage among adolescents and young adults, thereby preventing HPV-related cancers. By establishing a clear recommendation for routine vaccination at ages 9 to 12, the ACS aims to improve on-time vaccination rates and ultimately reduce the incidence of cancers caused by HPV.
Main Methods and Findings: The ACS recommends initiating the HPV vaccination series at ages 9 or 10, emphasizing the importance of early vaccination to maximize effectiveness. The guidelines advocate for catch-up vaccinations for individuals up to age 26 who have not received adequate doses. For those aged 22 to 26, healthcare providers are urged to communicate the diminished effectiveness of vaccination in reducing cancer risk if they have not completed the series. Notably, the ACS does not support the 2019 recommendation for shared decision-making for adults aged 27 to 45, citing low effectiveness and potential burden on both patients and clinicians due to insufficient guidance.
Core Conclusions: The ACS guidelines underscore the significance of early HPV vaccination, reinforcing that starting the vaccination series at ages 9 to 12 is crucial for optimal protection against HPV-related cancers. The recommendation for catch-up vaccinations up to age 26 aims to ensure that young adults have the opportunity to be vaccinated before the effectiveness wanes. However, the decision against recommending catch-up vaccinations for those older than 26 highlights a strategic focus on populations where vaccination can have a meaningful impact on cancer prevention.
Research Significance and Impact: This guideline adaptation is pivotal as it not only aligns with the broader public health objective of reducing cancer incidence but also addresses the practical aspects of vaccination implementation. By clarifying the age ranges for vaccination and catch-up strategies, the ACS seeks to streamline the decision-making process for healthcare providers and promote health equity. The emphasis on early vaccination is expected to lead to a significant decrease in HPV-related cancers, thereby having a lasting impact on public health outcomes. Furthermore, by not recommending vaccinations for older adults with low effectiveness, the ACS helps prevent unnecessary healthcare expenditures and focuses resources on more effective preventive measures for younger populations.
Literatures Citing This Work
- Screening for Cervical Cancer. - Terresa J Eun;Rebecca B Perkins - The Medical clinics of North America (2020)
- Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison. - Giorgio Bogani;Francesco Raspagliesi;Francesco Sopracordevole;Andrea Ciavattini;Alessandro Ghelardi;Tommaso Simoncini;Marco Petrillo;Francesco Plotti;Salvatore Lopez;Jvan Casarin;Maurizio Serati;Ciro Pinelli;Gaetano Valenti;Alice Bergamini;Barbara Gardella;Andrea Dell'Acqua;Ermelinda Monti;Paolo Vercellini;Giovanni D'ippolito;Lorenzo Aguzzoli;Vincenzo D Mandato;Paola Carunchio;Gabriele Carlifante;Luca Gianella;Cono Scaffa;Francesca Falcone;Stefano Ferla;Chiara Borghi;Antonino Ditto;Mario Malzoni;Andrea Giannini;Maria Giovanna Salerno;Viola Liberale;Biagio Contino;Cristina Donfrancesco;Michele Desiato;Anna Myriam Perrone;Giulia Dondi;Pierandrea De Iaco;Umberto Leone Roberti Maggiore;Mauro Signorelli;Valentina Chiappa;Simone Ferrero;Giuseppe Sarpietro;Maria G Matarazzo;Antonio Cianci;Sara Bocio;Simona Ruisi;Rocco Guerrisi;Claudia Brusadelli;Lavinia Mosca;Raffaele Tinelli;Rosa De Vincenzo;Gian Franco Zannoni;Gabriella Ferrandina;Salvatore Dessole;Roberto Angioli;Stefano Greggi;Arsenio Spinillo;Fabio Ghezzi;Nicola Colacurci;Margherita Fischetti;Annunziata Carlea;Fulvio Zullo;Ludovico Muzii;Giovanni Scambia;Pierluigi Benedetti Panici;Violante Di Donato - Vaccines (2020)
- Coronavirus 2019 Infectious Disease Epidemic: Where We Are, What Can Be Done and Hope For. - Michele Carbone;John Lednicky;Shu-Yuan Xiao;Mario Venditti;Enrico Bucci - Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (2021)
- A National Survey of Obstetrician/Gynecologists' Knowledge, Attitudes, and Beliefs Regarding Adult Human Papillomavirus Vaccination. - Monica L Kasting;Katharine J Head;Andrea L DeMaria;Monica K Neuman;Allissa L Russell;Sharon E Robertson;Caroline E Rouse;Gregory D Zimet - Journal of women's health (2002) (2021)
- Including vaccinations in the scope of dental practice: The time has come. - Alessandro Villa;Milda Chmieliauskaite;Lauren L Patton - Journal of the American Dental Association (1939) (2021)
- Nanomaterials for Protein Delivery in Anticancer Applications. - Anne Yau;Jinhyung Lee;Yupeng Chen - Pharmaceutics (2021)
- In the Name of Prevention: Maternal Perspectives on School-Based HPV Vaccination in Rural Southern Chile. - Ryan Arams;Rachel E Weinstock;Emma Satterthwaite Muresianu;Stasha O'Callaghan;Elizabeth Tubridy;Yumarlin Torres Maita;Siobhan M Dolan - Adolescent health, medicine and therapeutics (2021)
- Human Papilloma Virus Vaccination. - Kendal Rosalik;Christopher Tarney;Jasmine Han - Viruses (2021)
- Gaps and Opportunities to Improve Prevention of Human Papillomavirus-Related Cancers. - Irene O Aninye;J Michael Berry-Lawhorn;Paul Blumenthal;Tamika Felder;Naomi Jay;Janette Merrill;Jenna B Messman;Sarah Nielsen;Rebecca Perkins;Tami Rowen;Debbie Saslow;Connie Liu Trimble;Karen Smith-McCune - Journal of women's health (2002) (2021)
- Vaccination against Cancer or Infectious Agents during Checkpoint Inhibitor Therapy. - Tahseen H Nasti;Christiane S Eberhardt - Vaccines (2021)
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