The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study
Abstract
Background Human papillomavirus (HPV) immunisation with a bivalent vaccine (Cervarix) was introduced in England, UK, in Sept 1, 2008: routine vaccination was offered to girls aged 12-13 years with a catch-up programme for females aged 14-18 years in 2008-10. We quantified the early effect of this immunisation programme on cervical cancer and cervical carcinoma in situ, namely grade 3 cervical intraepithelial neoplasia (CIN3), registrations. Methods In this observational study, we used an extension of the age-period-cohort Poisson model to estimate the relative risk of cervical cancer in three vaccinated cohorts compared with earlier cohorts that were not eligible for HPV vaccination. Data from a population-based cancer registry were extracted on Jan 26, 2021, and were assessed for diagnoses of cervical cancer and CIN3 from Jan 1, 2006 to June 30, 2019 in women aged 20-64 years and who were a resident in England. We used three vaccinated cohorts to account for differences in the school year in which the vaccine was offered and its national coverage. Adjustment for confounding was made using information on changes in cervical screening policy and historical events that affected cervical cancer incidence. Results were compared across models with different adjustments for confounders. Findings We used data from a total of 13·7 million-years of follow-up of women aged 20 years to younger than 30 years. The estimated relative reduction in cervical cancer rates by age at vaccine off…
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HPV vaccines have demonstrated high efficacy for three-dose and two-dose schedules.
“The licensed prophylactic human papillomavirus (HPV) vaccines protect against infection with vaccine-targeted HPV types, precancerous lesions, and invasive cervical cancer, have demonstrated high efficacy for three-dose and two-dose schedules,3, 4 and have consistently been shown to be safe.5”
From Evidence-based impact projections of single-dose human papillomavirus vaccination in India: a modelling study (2022) · cites this paper as [4]
Cites
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The importance of long-term follow up of participants in clinical trials
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Cancer of the cervix uteri: 2025 update
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“5,6 10–12 Although cervical screening guidelines vary slightly across different regions, they typically recommend that screening should start between the ages of 20 and 30 years old.”
- Authors
- Falcaro, M., Castañon, A., Ndlela, B., Checchi, M., Soldan, K., Lopez-Bernal, J., Elliss-Brookes, L., & Sasieni, P.
- Affiliations
- King's College London (GB)
- Public Health England (GB)
- Guy's Hospital (GB)
- Corresponding author
- Sasieni, Peter
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 398
- Issue
- 10316
- Pages
- 2084-2092
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W3209481766
- Cited by
- 785
- References
- 1
- Citations by year
- 2026: 143 · 2025: 166 · 2024: 165 · 2023: 149 · 2022: 151 · 2021: 11
- FWCI
- 85.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Funders
- King's College London
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- HPV vaccination, cervical cancer incidence, cervical carcinoma in situ, Cervarix, vaccine impact, age at vaccination, catch-up vaccination, cervical cancer prevention, cervical cancer mortality
- MeSH terms
- Adolescent, Adult, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Child, England, Female, Humans, Immunization, Middle Aged, Registries, Vaccination, Incidence, Papillomavirus Infections, Papillomavirus Vaccines, Early Detection of Cancer
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