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New Study Reveals HPV vaccine Significantly Reduced Cervical Cancer Risk


Cervical cancer and CIN3 rates are significantly reduced by the bivalent HPV vaccine.

New Study Reveals HPV vaccine Significantly Reduced Cervical Cancer Risk
Image: Human Papillomavirus | InStyleHealth

According to an observational study from England, the risk of cervical cancer and grade 3 cervical intraepithelial neoplasia (CIN3) was significantly reduced among girls who were given the bivalent human papillomavirus (HPV) vaccine, particularly those who were given it around the age of 12–13 years.


"We discovered a significant reduction in cervical cancer rates in all three vaccinated cohorts, particularly in those who were provided the vaccination in school year 8 (aged 12–13 years)," the authors noted.


"As expected, vaccination against HPV was most successful in the cohorts immunized at ages 12–13, among whom the uptake was largest and prior infection was least likely," stated study co-author Dr Kate Soldan of Public Health England's National Infection Service in London, UK.


"This study shows a considerable reduction in cervical cancer rates in vaccinated cohorts, providing the first direct evidence of the impact of the UK HPV vaccination campaign on cervical cancer incidence," Soldan explained.


In September 2008, HPV immunization with a bivalent vaccine became a regular vaccination for females aged 12–13 years in England. In 2008–2010, a catch-up program for females aged 14–18 years was also implemented.


Female residents aged 20–64 years who were diagnosed with cervical cancer or CIN3 between January 2006 and June 2019 were identified using data from a population-based cancer registry. During the 13.7 million-years of follow-up, a total of 27,946 instances of cervical cancer and 318,058 cases of CIN3 were diagnosed in women aged 20 to 30 years.


Girls between the ages of 16 and 18 who were provided the HPV vaccine had a 34% lower risk of cervical cancer than uninfected women. [Lancet 2021;398:2084-2092] [Lancet 2021;398:2084-2092]


This relative risk decrease was considerably greater among girls aged 14–16 and 12–13 years, with a 62 percent and 87 percent reduction in risk, respectively. 89 percent of those in the latter group had received at least one dose of the HPV vaccine, and 85 percent had received all three doses.


Similarly, as compared to uninfected women, those who were provided the HPV vaccine at the ages of 16–18, 14–16, and 12–13 years saw a 39 percent, 75 percent, and 97 percent reduction in the risk of CIN3, respectively.


By June 2019, it was anticipated that there were 448 fewer than expected incidences of cervical cancer and 17,235 fewer than expected cases of CIN3 among vaccinated cohorts in England.


"This [research] is a significant step forward in the prevention of cervical cancer." "We hope that these new findings boost vaccination uptake because the success of the immunization campaign is determined not only by the vaccine's efficiency but also by the proportion of the population that has been vaccinated," Soldan added.


The authors noted that the HPV vaccine offer in this study only pertains to age groups and does not take into account unobserved characteristics like behavior and lifestyle. Furthermore, there were no data on individual-level efficacy or HPV types for each cancer case. They also mentioned that the incidence of cervical cancer in young women, such as the cohort analyzed here, is low.


"Cervical cancer incidence fluctuates fast with age and is influenced by screen-detected malignancies, particularly on the initial screen," they said. "Over time, the precise age of initial screening and screening uptake fluctuates. Even little changes to cervical screening (or the reporting of cervical histology) or cancer registration could have a big impact on CIN3 trends in women in their 20s."


Professors Maggie Cruickshank of the University of Aberdeen, Aberdeen, UK, and Mihaela Grigore of the University of Medicine and Pharmacy "Grigore T Popa" Lasi, Lasi, Romania, wrote in a commentary, "The relative reductions in cervical cancer expected as a result of the HPV vaccination program support the anticipated vaccine effectiveness." [Lancet 2021;398:2053-2055] [Lancet 2021;398:2053-2055]


"The magnitude of the HPV vaccination effect reported in this study should also encourage vaccination programs in low- and middle-income countries, where the problem of cervical cancer is a far greater public health issue than in countries with well-established vaccination and screening systems," researchers stated.


"Aside from vaccine availability, the most critical issue... is educating the community to accept vaccination because a high rate of immunization is a key part of success," they noted.

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