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. 2025 Apr:195:134-143.
doi: 10.1016/j.ygyno.2025.03.008. Epub 2025 Mar 18.

Validating the predicted impact of HPV vaccination on HPV prevalence, cervical lesions, and cervical cancer: A systematic review of population level data and modelling studies

Daniël de Bondt  1 , Emi Naslazi  2 , Erik Jansen  2 , Rachel Kupets  3 , Bronwen McCurdy  3 , Christine Stogios  3 , Inge de Kok  2 , Jan Hontelez  4
Affiliations
Free article

Validating the predicted impact of HPV vaccination on HPV prevalence, cervical lesions, and cervical cancer: A systematic review of population level data and modelling studies

Daniël de Bondt et al. Gynecol Oncol. 2025 Apr.
Free article

Abstract

Background: We compared model predictions with independently published primary data from population-based studies on the impact of HPV vaccination on HPV prevalence, cervical cancer and its precursors.

Methods: We searched Cochrane Library, EMBASE, MEDLINE, Web of Science for studies concerning high-income countries published between 2005 to June 2, 2023. Relative risk (RR) for HPV-related outcomes comparing the pre-vaccination and post-vaccination periods were collected from observational and modelling studies. The relationship between vaccination coverage and observed relative reductions was determined using meta-regressions, and we compared model prediction to observations.

Findings: We identified a total of 5649 potential articles, of which one systematic review, 14 observational studies and 32 modelling studies met our inclusion criteria. A clear relation was found between the RR of HPV diseases related outcomes in the pre- versus post-vaccination era and the vaccination coverage, with 23 out of 28 data points and 19 out of 20 data points showing significant reductions in HPV prevalence and CIN2+ prevalence respectively. Around 67 % (n/N = 12/18) of model predictions were more optimistic on HPV prevalence reductions compared to the 95 % CI of the meta-regression derived from observational studies. For CIN2+ lesions, 48 % (n/N = 31/64) of model predictions for CIN2+ outcomes fell within the 95 % CI.

Interpretation: Model predictions and observational data agree that HPV vaccination can have a substantial impact on HPV related outcomes on a population level. Despite large heterogeneity in observational data and modelling studies, it is particularly encouraging that model predictions on the impact of HPV vaccination on CIN2+ model lesions align with observational studies.

Funding: Ontario Health (formerly known as Cancer Care Ontario).

Keywords: Cervical cancer; HPV vaccination; meta-regression.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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