Scottish HPV vaccine programme dramatically reduced cervical disease, study shows

HPV research

Dr Kevin Pollock co-authored the study published in the BMJ

Researchers in Scotland have investigated the impact of the HPV (human papillomavirus) vaccine given to schoolgirls in the country. This virus is mainly transmitted between people having vaginal, anal or oral sex. Of these over 4,200 cases, 338 were identified as not belonging to the most common types of cervical cancer (squamous epithelial cancer and adenocarcinoma).

The UK-wide vaccination programme launched for girls a decade ago has been so successful that it will be extended to boys this year. This meant that Scotland obtained screening data for the 2008-09 cohort before the change in screening age.

Routine vaccination of girls aged 12 or 13 years with the human papillomavirus (HPV) vaccine in Scotland has led to a dramatic reduction in cervical disease in later life, finds a study published by The BMJ today.

For the first time, we can now confirm that the vaccination programme has begun to profoundly alter the prevalence of HPV 16 and 18 among Scottish women - and presumably elsewhere as well.

There was a bigger decline in disease among those vaccinated at the age of 12 or 13 (89%) than in those vaccinated at 17 (51%). Though not all pre-cancer becomes cancer, all cancer requires pre-cancer.

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The team, led by Tim Palmer at the University of Edinburgh, analysed vaccination and screening records for 138,692 women born between 1988 and 1996 who had a screening test result recorded at age 20. This is a fall in incidence from 1.44% to 0.17%. This is particularly good news, since this group is also less likely to attend cervical screenings.

'It also feeds into our policy calls for a new IT infrastructure (for the screening programme in England) to record and enable invitations based on whether someone has at the vaccine if intervals can be extended'.

"The findings emphasise the credibility of using high-risk HPV infection as an early marker of the effectiveness and success of the vaccine and underpin the recent call for global action on cervical cancer from the World Health Organization", they said. The obvious conclusion is that we are going to see far fewer cases of cervical cancer in years to come.

The study, which appears in "AIDS Patient Care and STDs", found that there was already reports of higher rates of HPV-related cancers in gay minority men who were older and still sexually active.

"Low levels of cervical cancer after routine vaccination clearly have ramifications for screening vaccinated women", the study said. The higher the number, the higher the risk is of developing invasive cancer.

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