Bivalent HPV vaccination at age 12 to 13 years prevents cervical cancer

Key takeaways:

• HPV vaccination at age 12 to 13 years prevents cervical cancer development.
• Receiving three HPV vaccine doses at age 14 to 22 years significantly reduces invasive cervical cancer incidence.

HPV vaccination with one or two doses at age 12 to 13 years prevents invasive cervical cancer development, researchers reported in the Journal of the National Cancer Institute.

“Cervical cancer will become an uncommon disease in women who have been fully vaccinated at age 12 to 13 years. The current vaccines will not prevent all cases of cancer because the vaccines only cover some the HPV types known to cause cancer,” Tim J. Palmer, BSc, MBBS, MRCP, FRCPath, consultant in public health medicine at the Public Health Scotland, honorary senior lecturer at the University of Edinburgh and prior Scottish clinical lead for cervical screening, told Healio. “HPV immunization before sexual debut and appropriate cervical screening will both be needed to achieve the WHO target of elimination of cervical cancer. It will be important to consider how to target interventions at difficult-to-reach groups.”

Palmer and colleagues conducted a population-based observational study evaluating data from 447,955 women born from 1988 to June 1996 from the Scottish cervical cancer screening system. These data were linked to cancer registry, immunization and deprivation data. Researchers assessed invasive cervical cancer incidence per 100,000 person-years and HPV vaccine effectiveness and correlated these data with vaccination status, age at vaccination and deprivation.

Researchers observed no invasive cancer cases recorded among women who were immunized at age 12 or 13 years, irrespective of the number of doses. Women who were vaccinated at age 14 to 22 years and were given three bivalent vaccine doses had a significant reduction in invasive cervical cancer incidence compared with all unvaccinated women (3.2 vs. 8.4 per 100,000 person-years).

Women from the most deprived areas, measured by the Scottish Index of Multiple Deprivation, had significantly higher unadjusted incidence for invasive cervical cancer compared with women from the least deprived areas (10.1 vs. 3.9 per 100,000 person-years). In addition, women from most deprived areas had a significant reduction in invasive cervical cancer incidence after receiving three HPV vaccine doses compared with women from least deprived areas (13.1 vs. 2.29 per 100,000 person-years).

According to Palmer, HPV vaccination has had such a profound effect on HPV infection amdong immunized women that it is imperative to gather new information on present HPV types in the wider population, in cervical cancer precursors and in cancers themselves.

“We need to monitor the clinical and virological data to understand how the disease is changing and what that means for women. We need to follow women for many years, through screening, to make sure that the protection is long-lasting; all indications so far are that the protection is good and lasts a long time,” Palmer said. “Scotland, using our linking of data sources and comprehensive nationwide cervical screening system, has already started on this second phase of surveillance.”