The introduction of the HPV vaccination program in England in 2008 brought significant public health benefits. The vaccination, initially aimed at girls aged 12-13, has demonstrated substantial efficacy in reducing cervical cancer and grade 3 cervical intraepithelial neoplasia (CIN3), according to the recent findings from this study.
The study evaluated the program’s impact across various socioeconomic groups, revealing a remarkable 83.9% reduction in cervical cancer and a 94.3% reduction in CIN3 in women vaccinated at ages 12-13. “We found the HPV vaccination program to be highly effective across all groups,” stated Peter Sasieni, one of the lead researchers. However, the research highlighted that women in more deprived areas still experience higher cervical cancer rates, although the gap is closing.
The analysis followed women aged 20-64 from January 2006 to June 2020. Vaccination was offered routinely starting in 2008, with a catch-up campaign for older teenagers. Over 29,000 women were diagnosed with cervical cancer during the study period. Importantly, the program’s effect was observed in both vaccinated and unvaccinated groups, with significantly lower cancer rates among those vaccinated.
Impact on Deprived Areas
While vaccination showed positive outcomes across all socioeconomic groups, women from the most deprived areas continue to experience higher rates of cervical cancer and CIN3 compared to their counterparts in more affluent regions. Yet, the program has narrowed this disparity significantly. Kate Soldan from the UK Health Security Agency emphasized, “This study shows that the vaccination is benefiting even the most disadvantaged groups.”
Vaccination Catch-Up Campaign
The catch-up campaign, targeting women aged 16-18, also showed success, albeit with varying effectiveness across socioeconomic groups. Women from the least deprived areas experienced a greater reduction in CIN3, while reductions in the most deprived areas were smaller but still significant. “The disparities in cervical disease are gradually being addressed, but challenges remain,” said Milena Falcaro, a contributing researcher.
Future Directions
The study suggests continued focus on increasing vaccination uptake, particularly in deprived areas, to further reduce health inequalities. Encouragingly, the downward trend in cervical cancer incidence is expected to continue as more cohorts of vaccinated women reach the age where screening begins.
Citation:
Falcaro M, Soldan K, Ndlela B, Sasieni P. Effect of the HPV vaccination programme on incidence of cervical cancer and grade 3 cervical intraepithelial neoplasia by socioeconomic deprivation in England: population based observational study. BMJ. 2024;385. doi:10.1136/bmj-2023-077341.
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