Global estimates of expected and preventable cervical cancers among girls born between 2005 and 2014: a birth cohort analysis
Open accessAbstract
BACKGROUND: WHO has launched an initiative aiming to eliminate cervical cancer as a public health problem. Elimination is a long-term target that needs long-lasting commitment. To support local authorities in implementing human papillomavirus (HPV) vaccination, we provide regional and country-specific estimates of cervical cancer burden and the projected impact of HPV vaccination among today's young girls who could develop cervical cancer if not vaccinated. METHODS: The expected number of cervical cancer cases in the absence of vaccination among girls born between 2005 and 2014 was quantified by combining age-specific incidence rates from GLOBOCAN 2018 and cohort-specific mortality rates by age from UN demographic projections. Preventable cancers were estimated on the basis of HPV prevalence reduction attributable to vaccination and the relative contribution of each HPV type to cervical cancer incidence. We assessed the number of cervical cancer cases preventable through vaccines targeting HPV types 16 and 18, with and without cross-protection, and through vaccines targeting HPV types 16, 18, 31, 33, 45, 52, and 58. FINDINGS: Globally, without vaccination, the burden of cervical cancer in these birth cohorts is expected to reach 11·6 million (95% uncertainty interval 11·4-12·0) cases by 2094. Approximately 75% of the burden will be concentrated in 25 countries mostly located in Africa and Asia, where the future number of cases is expected to increase manyfold, reaching 5·6 million (5·4-6·0) cases in Africa and 4·5 million (4·4-4·6) cases in Asia. Worldwide immunisation with an HPV vaccine targeted to HPV types 16 and 18, with cross-protection against HPV types 31, 33, and 45, could prevent about 8·7 million (8·5-9·0) cases. INTERPRETATION: Detailed estimates of the increasing burden of cervical cancer and projected impact of HPV vaccination is of immediate relevance to public health decision makers. Shifting the focus of projections towards recently born girls who could develop cervical cancer if not vaccinated is fundamental to overcome stakeholders' hesitancy towards HPV vaccination. FUNDING: Bill & Melinda Gates Foundation, Canadian Institutes of Health Research.
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Among 2005-14 birth cohorts worldwide, the largest burden of cervical cancer is projected in low-income and middle-income countries, with close to a sixth of cases projected to be in India, making it the country with the highest expected burden.
“Among 2005–14 birth cohorts worldwide, the largest burden of cervical cancer is projected in low-income and middle-income countries, with close to a sixth of cases projected to be in India, making it the country with the highest expected burden.7”
From Evidence-based impact projections of single-dose human papillomavirus vaccination in India: a modelling study (2022) · cites this paper as [7]
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- Authors
- Bonjour, M., Charvat, H., Franco, E. L., Piñeros, M., Clifford, G. M., Bray, F., & Baussano, I.
- Affiliations
- Lyon 1 Université (FR)
- Centre international de recherche sur le cancer (FR)
- McGill University (CA)
- Corresponding author
- Baussano, Iacopo
- ORCID
- Venue
- The Lancet Public Health
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 6
- Issue
- 7
- Pages
- e510-e521
- ISSN
- 2468-2667 (ISSN-L)
- PMC
- PMC8225515
- OpenAlex
- W3155324950
- Cited by
- 73
- References
- 28
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 12 · 2023: 25 · 2022: 9 · 2021: 7
- FWCI
- 9.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- Centre International de Recherche sur le Cancer
- World Health Organization
- Bill & Melinda Gates Foundation (OPP 1188709, INV-005318)
- 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
- cervical cancer, HPV vaccination, human papillomavirus, cancer burden projections, birth cohort, cross-protection, HPV 16/18, cervical cancer elimination, Africa, Asia
- MeSH terms
- Global Burden of Disease, Uterine Cervical Neoplasms, Female, Humans, Global Health, Papillomavirus Infections, Mass Vaccination, Papillomavirus Vaccines
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