# Optimizing cervical cancer screening for HPV-vaccinated women: Evaluation of post-vaccination cervical cancer screening test

> **NIH AHRQ R03** · UNIVERSITY OF MINNESOTA · 2020 · $45,234

## Abstract

ABSTRACT
The HPV vaccine is highly effective in clinical trials, with an absolute risk of persistent (6+ months) infection
with vaccine-type high-risk HPV of only 1.4% among vaccinated women. As prevalence of HPV infection
decreases, the risk of false positive cervical cancer screening results increases. However, current cervical
cancer screening guidelines do not differentiate between vaccinated and unvaccinated women. Data cannot
be extrapolated from other countries with different HPV vaccination coverage, as cross-protection against non-
vaccine type HPV infection varies by population vaccination rates, and are likely to affect screening test
performance. Major challenges in development of new U.S. guidelines are anticipated for the following
reasons: 1) large U.S. population-based data on HPV infection rates and cervical cancer screening test
statistics are currently not available, and likely vary by regional vaccination rates; 2) most studies evaluating
cervical cancer screening results in vaccinated women do not differentiate between those who have received
only 1 dose of the vaccine and those who have completed the 2-3 dose series; 3) few studies have evaluated
differences in outcomes by age at HPV vaccine initiation or interval between doses.
The overarching aim of the proposed research is to determine an optimal cervical cancer screening strategy for
women vaccinated against HPV. The objectives of this pilot research are to 1) determine if the prevalence of
cervical dysplasia has decreased with HPV vaccination and resultantly changed the PPV of cervical cancer
screening tests, and 2) determine if cervical cancer screening test performance varies by age at HPV vaccine
initiation, number of doses, or interval between HPV vaccine doses.
Aim1: Determine if the decrease in prevalence of cervical dysplasia among vaccinated women has resulted in
a decrease in the positive predictive value of cervical cancer screening tests. A cross-sectional study will be
conducted to compare cervical cancer screening and diagnostic test results among HPV-vaccinated and
unvaccinated women. Positive predictive values for positive HPV tests and abnormal cytology results to predict
high-grade dysplasia will be compared by HPV vaccination status.
Aim2: Determine if cervical cancer screening test accuracy varies by age at vaccine initiation, number of doses
received, and/or interval between doses. The positive predictive value of positive HPV tests and abnormal Pap
test results among vaccinated women will be compared by the number of vaccine doses received (1 vs. 2+),
age at vaccine initiation, and interval between doses using logistic regression.

## Key facts

- **NIH application ID:** 9936304
- **Project number:** 5R03HS026982-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Deanna GK Teoh
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $45,234
- **Award type:** 5
- **Project period:** 2019-06-01 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9936304

## Citation

> US National Institutes of Health, RePORTER application 9936304, Optimizing cervical cancer screening for HPV-vaccinated women: Evaluation of post-vaccination cervical cancer screening test (5R03HS026982-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9936304. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*