OnCo
ideasIdea

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

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

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.

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.
What would test it
1,500-woman RCT in treated women; pragmatic uptake pilot in screening clinics.
Maturity
early clinical
Who has to act
clinic
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks

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