Reply

Abstract

In regard to: "Why is it appropriate to recommend human papillomavirus vaccination as cervical cancer prevention?" TO THE EDITORS: I would like to commend the authors on a very informative and well-reasoned article on the safety and appropriateness of the human papillomavirus (HPV) vaccine and its relationship to cervical cancer prevention. Two of the major concerns about the HPV vaccine are raised, summarized, and subsequently dispelled. 1 The authors raise a critical point in that "deemphasizing the role of HPV vaccine in cervical cancer prevention in women at risk for developing cervical cancer may allow racial, ethnic, and socioeconomic disparities in cervical cancer to continue unchecked." 1 In a 2014 article, Bruno et al. 2 also note that a lack of time to educate patients, a lack of preventative care visits, and cost may be a barrier. What do the authors recommend to improve provider promotion of HPV vaccines, particularly in high-risk populations? Disparities in preventative care are a real tragedy, and I applaud the authors for raising this very important point. As health professionals, it should be all of our responsibilities to ensure best care regardless of race, ethnicity, and socioeconomic status. The authors discuss only the role of Pap smear in cervical cancer screening. There is a global move towards primary HPV testing; recommendations are now available in the United States and Canada. 3,4 I would be very interested to hear their thoughts on the move toward HPV testing for cervical cancer screening in conjunction with vaccination programs.