{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T12:07:25Z","timestamp":1773317245909,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T00:00:00Z","timestamp":1607990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C8162\/A25356"],"award-info":[{"award-number":["C8162\/A25356"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C8162\/A27047"],"award-info":[{"award-number":["C8162\/A27047"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the demand for colposcopy in the Cervical Screening Wales programme after the introduction of human papillomavirus (HPV) cervical screening, which coincided with the start of screening of women vaccinated against HPV types 16\/18.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The study used a computational model that assigns screening and screening\u2010related colposcopy events to birth cohorts in individual calendar years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Cervical Screening Wales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women aged 25\u201364\u00a0years from birth cohorts 1953\u20132007.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and main outcome measures<\/jats:title><jats:p>We estimated the numbers of colposcopies and high\u2010grade cervical intraepithelial lesions (CIN2+) within Cervical Screening Wales in 2018\u201332, using official population projections for Wales and published estimates of the effects of HPV screening and vaccination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vaccination will reduce the number of colposcopies by 10% within the first 3\u20134\u00a0years after the national roll\u2010out of HPV screening, and by about 20% thereafter. The number of screening colposcopies is estimated to increase from 6100 in 2018 and peak at 8000 (+31%) in 2021, assuming current screening intervals are maintained. The numbers of CIN2+ lesions follow similar patterns, stabilising at around 1000 diagnoses per year by 2026, approximately 60% lower than at present. Extending the screening intervals to 5\u00a0years for all women shows similar trends but introduces peaks and troughs over the years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Vaccination will not fully prevent an increase in colposcopies and detected CIN2+ lesions during the first 2\u20133\u00a0years of HPV\u2010based screening but the numbers are expected to decrease substantially after 5\u20136\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>HPV\u2010based cervical screening will initially increase colposcopy referral. In 6\u00a0years, this increase will be reversed, partly by HPV vaccination.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16610","type":"journal-article","created":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T20:17:37Z","timestamp":1606594657000},"page":"1226-1235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Introducing human papillomavirus (HPV) primary testing in the age of HPV vaccination: projected impact on colposcopy services in Wales"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2054-7930","authenticated-orcid":false,"given":"F","family":"Pesola","sequence":"first","affiliation":[{"name":"Cancer Prevention Group School of Cancer &amp; Pharmaceutical Sciences Faculty of Medicine and Life Sciences King\u2019s College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-645X","authenticated-orcid":false,"given":"M","family":"Rebolj","sequence":"additional","affiliation":[{"name":"Cancer Prevention Group School of Cancer &amp; 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Pharmaceutical Sciences Faculty of Medicine and Life Sciences King\u2019s College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,15]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1439","article-title":"The problem of false\u2010positive human papillomavirus DNA tests in cervical screening","volume":"19","author":"Rebolj M","year":"2013","journal-title":"Curr Pharm Des"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14562"},{"key":"e_1_2_7_4_1","volume-title":"Written Statement: Cervical Screening","author":"Vaughan G","year":"2019"},{"key":"e_1_2_7_5_1","volume-title":"Cervical Screening Wales Annual Statistical Report 2017\u201018","author":"Public Health Wales","year":"2018"},{"key":"e_1_2_7_6_1","volume-title":"2016\u2010based National Population Projections","year":"2017"},{"key":"e_1_2_7_7_1","volume-title":"Cervical Screening Programme: England, 2017\u201318","author":"NHS Digital","year":"2018"},{"key":"e_1_2_7_8_1","volume-title":"Note of the meeting held on 27 February 2019","author":"Committee UNS","year":"2019"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l240"},{"key":"e_1_2_7_10_1","volume-title":"National Immunisation uptake data: Quarterly COVER data","author":"Public Health Wales","year":"2019"},{"key":"e_1_2_7_11_1","volume-title":"HPV Primary Screening Pilots: Evaluation report to the National Screening Committee","author":"Moss S","year":"2015"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.309"},{"key":"e_1_2_7_13_1","first-page":"94","article-title":"POBASCAM, a population\u2010based randomized controlled trial for implementation of high\u2010risk HPV testing in cervical screening: design, methods and baseline data of 44,102 women","volume":"110","author":"Bulkmans NW","year":"2004","journal-title":"IntJCancer"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l1161"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.25726"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70296-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70360-2"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.22"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147326"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.04.012"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-019-0547-x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.2217\/WHE.13.48"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1375-9"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2009.07.022"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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