- WHO’s goal of cervical cancer reduction by the century’s end is possible but requires ≥90% HPV vaccination coverage in girls residing in low-income, low-middle-income countries (LMICs).
Why this matters
- A concerted effort is needed to intensively scale-up offer/improve HPV vaccine uptake in all adolescent and young adult female patients.
- Clinicians are urged to conduct HPV screening and to follow up in patients testing positive.
- Achieving 90% girls-only HPV coverage yields:
- 89.4% (range, 86.2%-90.2%) reduction in median age-standardized LMIC cervical cancer incidence.
- 61.0 million (range, 60.5-63.0 million) cases averted overall.
- HPV vaccine plus once-lifetime screening:
- 95.0% (range, 89.0%-95.3%) reduction in median age-standardized LMIC cervical cancer incidence.
- Another +6.8 million (range, 4.3-9.4 million) cases averted.
- HPV vaccine plus twice-lifetime screening:
- 96.7% (range, 91.3%-96.7%) reduced average age-standardized LMIC cervical cancer incidence;
- A total of 74.1 million (range, 70.4-75.1 million) cases averted.
- Vaccinating boys in addition to girls is insufficient to improve cancer rates in countries with highest age-standardized cervical cancer incidence (e.g., Uganda).
- Multiage cohort vaccination (to age 25 years) is ineffective against cervical cancer incidence at equilibrium.
- Comparative modeling analysis to identify HPV-prevention strategies, timing, and number of averted cervical cancer cases for different thresholds, country characteristics.
- Funding: WHO.
- Future confounders likely.
- Intensive scale-up assumed.
- HPV/HIV interactions unaccounted for.
- Underestimated cases.