Human Papillomavirus Infection and Cervical Cancer: Epidemiology, Screening, and Vaccination—Review of Current Perspectives

Table 1

WHO recommendations on cervical cancer screening and prevention in the low- and middle-income countries.

	Primary prevention: vaccination		Secondary prevention: screening
Methods	Inclusion of HPV vaccine in the national immunization schedule: (i) Bivalent; (ii) Tetravalent		(i) Cervical cytology (conventional Pap smear and liquid-based); (ii) Visual inspection with acetic acid (VIA)/visual inspection with Lugol’s iodine (VILI); (iii) HPV testing for high-risk HPV types (i.e., types 16, 18,31, 33, 45, and 58)
Target age group (years) and gender	Girls 9–14 years old	Girls over 15 years old	Women 30–49 years old
Frequency and intervals	2 doses	3 doses	(i) Once in life time; (ii) Once in 10 years; (iii) Once in 5 years; (a) VIA/cytology every 3- to 5-year interval; (b) HPV testing minimum every 5-year interval
	6-month interval	Bivalent: 0, 1, 6 months; tetravalent: 0, 2, 6 months
Programmatic consideration	School-based delivery strategy		(i) Organized program; (ii) Unorganized/opportunistic/sporadic initiatives; (a) Screen-and-treat approach; (b) Screen-diagnose-treat approach