HPV vaccination reduces cervical cancer incidence

  • Lei J & al.
  • N Engl J Med
  • 1 Oct 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Quadrivalent HPV vaccination was associated with a significant reduction in the incidence of cervical cancer in Swedish girls and women vaccinated during 2006-2017.
  • The reduction was even greater in women vaccinated before the age of 17 years.

Why this matters

  • The study extends the knowledge base by showing that quadrivalent HPV vaccination is also associated with a substantially reduced risk of invasive cervical cancer, which is the ultimate intent of HPV vaccination program.
  • The reduction was even greater in women vaccinated before the age of 17 years.

Study design

  • Swedish study of 1,672,983 girls and women (age, 10-30 years) during 2006-2017.
  • 527,871 women received ≥1 dose of the HPV vaccine and 1,145,112 women did not receive vaccine.
  • Funding: Swedish Foundation for Strategic Research; others.

Key results

  • Cervical cancer was diagnosed in 19 women (0.004%) who had received HPV vaccine vs 538 women (0.05%) who had not.
    • The cumulative incidence per 100,000 persons was 47 vs 94 cases.
    • The adjusted cervical cancer incidence rate ratio was 0.37 (95% CI, 0.21-0.57).
  • The risk reduction was greater in women who had been vaccinated before the age of 17 years vs at age 17-30 years.
    • The cumulative incidence per 100,000 persons was 4 vs 54 cases.
    • The incidence rate ratio was 0.12 (95% CI, 0.00-0.34) vs 0.47 (95% CI, 0.27-0.75).

Limitations

  • Misclassification bias.