HPV vaccine reduced cervical cancer by 90% in Scotland, study finds

Alicia Farmer
April 6, 2019

Scotland also has very detailed information about take-up rates, which have been very high: running to approximately 90% in Scotland for the routinely vaccinated girls and 65% for the older girls vaccinated as part of the catch-up programme.

Cervical cancer is caused by the Human papillomavirus, a common sexually transmitted infection. In 2008, routine HPV immunisation of 12 and 13-year-old girls was introduced in schools across the UK.

Researchers looked at the impact of routine vaccination on levels of abnormal cells and cervical lesions, known as CIN.

It retrieved 1,38,692 records and the researchers compared the data of unvaccinated women born in 1988 to vaccinated women born between 1995 and 1996.

"But because it knocks out these other three types, it is nearer 90% of cervical pre-cancer in Scotland."

Disease among unvaccinated women was also reduced possibly because of herd protection, according to the study.

Younger age at vaccination was associated with increasing vaccine effectiveness (86% for CIN grade 3 or worse for women vaccinated at age 12-13 compared with 51% for women vaccinated at age 17). She called for scaling up of HPV vaccination to countries where it is not yet available or accepted.

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The uptake rate in Scotland is now around 90%, while cervical cancer cases in women aged 20-24 have reduced by 69% since 2012.

79% reduction in CIN grade 1.

That's crucial because a CIN3 growth puts women at their greatest risk of someday developing cervical cancer.

The results show that women who had participated in the screening program on the last two occasions they were invited, were over 75 per cent and 65 per cent less likely to have developed adenosquamous and other rare types of cervical cancer, respectively, than women who had not been screened.

As expected, women who were older when vaccinated still had a lower rate of cervical disease than unvaccinated women, but not to the same degree as those who got the vaccine when young.

'It also feeds into our policy calls for a new IT infrastructure (for the screening programme in England) to record and enable invitations based on whether someone has at the vaccine if intervals can be extended'.

The growing success of the HPV vaccine might eventually lead to changes in how we screen women for cervical cancer, Palmer said, since there'll be fewer total cases of cancer to catch - a welcome problem, obviously. "We must also actively develop, resource, and scale up more effective, feasible and culturally acceptable strategies for cervical screening, such as self-collection of specimens, if we are ever to effectively reduce the global burden of cervical cancer". "Ultimately, the clinical and economic rationale for cervical screening will need to be reviewed".

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