Predicted impact of vaccination against human papillomavirus 16/18 on cancer incidence and cervical abnormalities in women aged 20-29 in the UK

Abstract

Background: Human papillomavirus (HPV) vaccination has been approved in more than 90 countries and is being implemented in many of these. In the UK, vaccination for girls aged 12-13 with catch-up for girls up to age 18 was introduced in 2008, using the bivalent GSK vaccine (Cervarix).

Methods: We modelled the proportion of abnormal smears, cervical intraepithelial neoplasia grade 3 (CIN3) and invasive cancer, which will be prevented in women aged 20-29 in the UK as a result of HPV vaccination.

Results: It will take many years for the full benefit of vaccination to be achieved. The earliest effects will be seen in women aged 20-29. With 80% coverage in women aged 12-13, we project an eventual 63% reduction in invasive cancer, a 51% reduction in CIN3 and a 27% reduction in cytological abnormalities before age 30. The full effect in this age group will not be seen until 2025, although half of the benefit will be seen by 2019 in England, where screening starts at age 25. However in Scotland and Wales, where screening starts at age 20, 50% of the benefit for CIN3 and abnormal smears (but not cancer) will be seen earlier.

Conclusion: Substantial reductions in disease can be anticipated by vaccination, but most of the benefit will not be apparent for at least another decade. High vaccine coverage is the key factor for achieving these benefits.

Figure 1

Predicted reduction in invasive cancer rates (with 80% coverage) in women aged 20–29 years.

Figure 2

Predicted reduction in CIN3 (with 80% coverage).

Figure 3

Predicted reduction in cytological abnormalities (with 80% coverage).