Background and objective:
Several studies had shown the effectiveness of vaccination against papillomavirus (HPV) in reducing hospitalization and severe prognosis due to cervical cancer. However, in Italy data on cervical cancer screening outcomes among HPV vaccinated women are still lacking. The purpose of this study is to evaluate outcomes cervical cancer screening among vaccinated women against HPV.

Methods:
Female residents in the Palermo area aged 25 years old were the eligible study population. Data on both quadrivalent and nonavalent HPV vaccination and cervical cancer screening (PAP test and HPV DNA test) were retrieved from informative dataset of Palermo local health unit (LHU) between 1st January and 30th November 2022. Descriptive and inferential statistical analyses were performed. Appropriated measures of central tendency (mean or median) and related dispersion measures (standard deviation [SD] or interquartile range [IQR], respectively) were chosen. Chi square test compared PAP test results with HPV vaccination, with p≤0.05 as statistically significant value.

Results:
Women invited to cervical cancer screening by Palermo LHU were 4718. No more than 8.4% (389) of them had a report of cervical cancer screening. The median age at first dose of HPV vaccine was 15 years old (IQR=13-21). Although the frequency of positive PAP test was higher among unvaccinated women compared with the vaccinated (68.4% vs 31.6%), it was not statistically significant (p=0.528). Also, the percentage of positive HPV DNA test was higher in the unvaccinated than the vaccinated (75.0% vs 25.0%), but this result was not statistically significant (p=0.553).

Conclusion:
Notwithstanding no evidence of the HPV vaccination effectiveness has been shown in this study population, vaccination data of Palermo LHU should be implemented, as well as increasing cervical cancer screening uptake. Since the high frequency of positive PAP/HPV DNA test among unvaccinated women, HPV vaccination should be promoted in early adolescence.