Human papillomavirus vaccination and cervical screening uptake among women presenting for abortion: exploring opportunities for health care interventions.
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BACKGROUND: Cervical cancer is predominantly caused by infection with high-risk human papillomavirus (HPV). Prevention efforts rely on vaccination and cervical screening. This study aimed to determine HPV vaccination and in-date cervical screening rates among women seeking abortion to determine whether this care setting could provide an opportunity to deliver catch-up prevention services. METHODS: Retrospective database study examining HPV vaccination and cervical screening coverage among women accessing abortion in Edinburgh, Scotland, UK from October to December 2024. National Health Service electronic systems recording HPV vaccinations and the Scottish Cervical Call Recall System were examined together with clinical records to determine if an in-person clinical visit was made as part of care. RESULTS: Some 798 individuals presented for abortion over the study period (n=297, ≤25 years and n=501, >25 years). Of those aged ≤25 years reviewed for HPV vaccination, 161/297 (54.2%) were vaccinated, 37 (12.5%) were unvaccinated and 99 (33.3%) had no record of vaccination status. Of the 501 women of cervical screening age >25 years, 289 (57.7%) were up to date, 70 (14%) were overdue and 142 (28.3%) had never been screened. Of the 37 unvaccinated individuals, 29 (78.4%) attended the clinic in person as did 158 (74.5%) of the 212 overdue/never-screened women. CONCLUSIONS: A significant proportion of those individuals who present for abortion are not vaccinated against HPV or up to date with cervical screening. Three-quarters of this group made an in-person visit, indicating an opportunity for delivering cervical cancer preventative services in the future. Future research is required to determine the feasibility of HPV vaccination and cervical screening in this setting.