{"entity":{"id":"paper-hpv-vaccine-england-lancet-2021","kind":"paper","name":"England's HPV programme: cervical cancer down 87% in the first cohort vaccinated at 12-13","aka":[],"tldr":"Ten years after England began vaccinating 12- to 13-year-olds with the bivalent HPV vaccine, cervical cancer in that cohort had fallen by 87% and severe precancer (CIN3) by 97%.","summary":"A population-based observational study used English cancer registry data from 2006 to 2019 to compare cervical cancer and CIN3 rates in cohorts offered the bivalent vaccine (Cervarix) at ages 12-13, 14-16 and 16-18 with earlier, unvaccinated cohorts, adjusting for changes in screening.\n\nRelative reductions in cervical cancer were 87% in the cohort offered vaccination at 12-13, 62% at 14-16 and 34% at 16-18. CIN3 fell by 97%, 75% and 39% respectively. The authors estimated about 450 fewer cervical cancers and 17,200 fewer CIN3 cases by mid-2019.\n\nThis confirmed the Swedish finding with a different vaccine and a school-based programme with high coverage.","asOf":"2026-09-08","links":[{"label":"DOI","url":"https://doi.org/10.1016/S0140-6736(21)02178-4"}],"tags":[],"related":["paper-hpv-vaccine-sweden-nejm-2020","idea-prev-hpv-vaccinate-at-screening","idea-prev-hpv-male-catchup-oropharynx"],"cancers":["cervical"],"sections":["prevention"],"technologies":["hpv-vaccine","hpv-testing"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-prevention-adoption","b-global-access"],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2021,"doi":"10.1016/S0140-6736(21)02178-4","pmid":"34741816","authors":"Falcaro M, Castañon A, Ndlela B, et al.","paperType":"observational","findings":["Cervical cancer reduced 87% (95% CI 72-94) in the cohort offered vaccine at age 12-13","Reduction of 62% (52-71) at 14-16 and 34% (25-41) at 16-18","CIN3 reduced 97% (96-98) in the youngest cohort","An estimated 448 fewer cervical cancers and 17,235 fewer CIN3 cases by June 2019"],"whatItMeans":"School-based vaccination at 12-13 with high uptake nearly abolishes cervical cancer in vaccinated cohorts, even with a vaccine covering only two HPV types. Screening intervals and the future of cervical screening can now be redesigned around vaccination status.","caveats":["Observational with a cohort comparison; changes in screening policy were adjusted for but cannot be fully excluded","Vaccinated cohorts were still young (under 28), so absolute numbers of cancers were small","Bivalent vaccine; England later switched to quadrivalent and nonavalent","Effects in populations with lower coverage will be smaller"],"changedPractice":true},"route":"/key-papers/paper-hpv-vaccine-england-lancet-2021/","neighbours":{"paper":[{"id":"paper-hpv-vaccine-sweden-nejm-2020","kind":"paper","name":"Swedish registry study: HPV vaccination almost eliminates cervical cancer when given before 17","route":"/key-papers/paper-hpv-vaccine-sweden-nejm-2020/"}],"idea":[{"id":"idea-prev-hpv-male-catchup-oropharynx","kind":"idea","name":"Catch-up HPV vaccination for men to prevent throat cancer","route":"/ideas/idea-prev-hpv-male-catchup-oropharynx/"},{"id":"idea-prev-hpv-vaccinate-at-screening","kind":"idea","name":"Offer HPV vaccination to women when they come for cervical screening or treatment","route":"/ideas/idea-prev-hpv-vaccinate-at-screening/"}],"cancer":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"technology":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"},{"id":"hpv-testing","kind":"technology","name":"HPV DNA testing and self-sampling","route":"/technologies/hpv-testing/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}],"person":[{"id":"peter-sasieni","kind":"person","name":"Peter Sasieni","route":"/people/peter-sasieni/"}],"collection":[{"id":"nhs-hpv-vaccination","kind":"collection","name":"NHS HPV vaccination programme","route":"/collections/nhs-hpv-vaccination/"}]}}