The first vaccine effective in preventing infections caused by the main human papillomaviruses responsible for cervical cancer (HPV 16 and 18) received marketing authorization in 2006. To aid in the decision regarding its potential inclusion in the French vaccination schedule, a health economic evaluation was conducted. It involved comparing the epidemiological impact and cost-effectiveness ratios of three options: organized screening for precancerous and cancerous cervical lesions, vaccination of adolescent girls, or a combination of these two strategies. A multi-generational Markovian model was developed, based on a previously published model, allowing for differences in time horizons between the two interventions. The model was parameterized using available data on current practices and their costs, for both screening and the management of precancerous and cancerous lesions. Data from the Alsatian pilot organized screening program were used. The model was calibrated by comparing it with incidence and mortality data for cervical cancer. Organized screening, and organized screening combined with vaccination of 80% of adolescent girls, would reduce the number of cervical cancers by 16% and 34%, respectively, compared to the current situation. The cost per additional life-year gained through vaccination in addition to screening would range, according to the assumed discount rate for benefits, between 27,500 and 55,500 euros when all medical costs are taken into account, and between 17,500 and 35,400 euros for the health insurance system. The cost-effectiveness analysis shows that priority should be given to organizing screening, but also that the simultaneous introduction of vaccination for adolescent girls before they become sexually active has a significant epidemiological impact and presents a cost-effectiveness ratio that appears acceptable, given generally accepted thresholds. These results were taken into account in the recommendation issued by the French High Council for Public Health in favor of organizing screening and vaccination for 14-year-old adolescent girls. (R.A.)