Cervical cancer: scaled-up HPV vaccine, screening could prevent 13 million cases by 2069

  • Simms KT et al
  • Lancet Oncol

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Widespread HPV vaccination, cervical screening from 2020 may potentially avert 12.5M-13.4M cervical cancer cases by 2069 to achieve annual incidence of 4 cases/100,000 or less for all country Human Development Index (HDI) categories by century’s end.
  • Assumes 80%-100% vaccination coverage is achieved for girls aged 12-15 years, all women are offered screening twice in their lifetime scaled up to 70% coverage globally.

Why this matters

  • Reinforce importance of screening, HPV vaccine series uptake/completion in all eligible female patients.

Key results

  • Cervical cancer expected to increase from 600K to 1.3M (2020-69), yielding 44.4M new cases, with two-thirds of burden in low-, medium-HDI countries.
  • Rapid scale-up (80%-90% coverage with nonvalent vaccine [Gardasil 9]) would avert 6.7M-7.7M cases (15%-17% reduction), but >50% averted from 2060 to 2069.
  • Vaccine plus 2 additional screenings would avert 5.7M-5.8M cases, resulting in 12.5M-13.4M cases averted (28%-30% reduction) for total incidence of 4 cases/100,000 from 2055 to 2059 (very-high-HDI) to 2090-2100 (low-HDI).

Study design

  • Statistical trends analysis modeling study quantifying cumulative potential effects of increased global HPV vaccination and screening from 2020 to 2069.
  • Funding: National Health and Medical Research Council Australia.

Limitations

  • Simplified assumptions (vaccine rates, cross-protection, geographical differences in sexual behavior, population standardization, catch-up vaccine, underestimated timelines for very-high-/high-HDI countries).

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