ASCO GUIDELINES Bundle

Cervical Cancer Prevention

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Recommendation C2b ➤ The interval between the doses should be at least 6 months and may be up to 12–15 months (6 months: Strong Recommendation; EB-H, 12–15 months: Moderate Recommendation; EB-L). Recommendation C3 ➤ High coverage of priority populations should be emphasized. Where coverage of the primary targeted group of females is high (≥50%) and resources allow, the age group may be expanded upward in catch-up efforts (Strong Recommendation; EB-H). Recommendation C4 b ➤ For prevention of cervical cancer in basic resource settings where vaccine coverage of girls is ≥50%, vaccination of boys is NOT recommended. • For prevention of cervical cancer, if there is low vaccine coverage of the priority female target population (<50%) in basic resource settings, then vaccination may be extended to boys (Moderate Recommendation; EB-I). In All Resource Settings Recommendation D ➤ Females who are HIV positive or immunosuppressed for other reasons should follow the same age recommendations but should receive three doses (Weak Recommendation; EB-Ins). Recommendation E ➤ HPV vaccination is not recommended for pregnant women (Weak Recommendation; EB-Ins). Recommendation F ➤ No vaccination strategy is recommended for women receiving treatment for cervical cancer precursor lesions (CIN2+; eg, conization, loop electrosurgical excision process, cryotherapy) (Ins). a Qualifying Statement for A4 and B4: Extending vaccination to boys to prevent cervical cancer is not cost-effective unless there is low vaccine coverage of the priority female target population (<50%). Vaccination may be extended to boys for other reasons, such as to prevent other noncervical HPV- related cancers and diseases (eg, genital warts) and/or to reduce circulating HPVs more rapidly. b Qualifying Statement for C4: Extending vaccination to boys to prevent cervical cancer is not cost-effective unless there is low vaccine coverage of the priority female target population (<50%). However, if resources allow for efforts to reduce noncervical cancers and diseases and/or reduce circulating HPVs more rapidly, then vaccination may be extended to boys. Additional Qualifying Statements: If boys are vaccinated, use the same age-related recommendations as for girls, according to resource settings. Recommendations regarding boys do not apply to men who have sex with men (MSM). Readers are referred to US CDC, Australian and other guidelines.

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