A photo of the HPV vaccine Gardasil with a stethoscope and clipboard.

After decades of research, the UK implemented a human papillomavirus (HPV) vaccine programme for teenage girls in 2008.

Now, for the first time, a study has shown that the UK HPV vaccine programme works and will save lives, according to research funded by Cancer Research UK.

In the first study of its kind, the vaccine was shown to dramatically reduce cervical cancer rates by almost 90% in women in their 20s who were offered it at age 12 to 13.

Results like this show the power of science.

– Michelle Mitchell, Cancer Research UK’s chief executive.

The study, published in The Lancet, shows the potential for HPV vaccination in combination with cervical cancer screening to reduce cervical cancer to the point where almost no-one develops it.

The researchers are based at King’s College London and the UK Health Security Agency (UKHSA) and the National Cancer Registration and Analysis Service (NCRAS) run by NHS Digital. Together, they estimated that the HPV vaccination programme prevented around 450 cervical cancers and around 17,200 cases of precancerous conditions over an 11 year period.

“It’s a historic moment to see the first study showing that the HPV vaccine has and will continue to protect thousands of women from developing cervical cancer,” said Michelle Mitchell, Cancer Research UK’s chief executive.

“Cancer Research UK has been funding research in this area for many years and we’ve been eagerly awaiting these results since the introduction of the vaccination programme. Around 850 women die from cervical cancer each year in the UK, so we have the chance to save many lives.”

The first of its kind using the UK vaccination programme

Almost all cervical cancers are caused by HPV – a link that was proven more than 20 years ago by Cancer Research UK scientists, overturning previous studies that had underestimated the link.

The HPV vaccine protects against the main cancer-causing strains of the virus: HPV 16 and 18. Protecting people against the infection helps to prevent abnormal changes in cervical cells, in turn leading to fewer cases of cervical cancer.

Previous results had confirmed that HPV vaccination is effective in preventing HPV infection, genital warts, and high-grade precancerous cell changes in the cervix.

But as the vaccine was only introduced in the 2000s, it hasn’t been possible until recently to definitely say the vaccine reduces cases of cervical cancer itself – the ultimate goal of the vaccination program. One study, coming from research conducted in Sweden, found that HPV vaccination was responsible for a 63% reduction in cervical cancer incidence.

This study is the first of its kind to focus on the UK vaccination programme, and the first ever to analyse the effectiveness of the bivalent cervical cancer vaccine (Ceravix). The team looked at all cervical cancers diagnosed in England in women aged 20 to 64 between January 2006 and June 2019.

And the results look extremely promising. The vaccine reduced cervical cancer incidence by 34% in those who received it aged 16 to 18, by 62% if aged 14 to 16 and by 90% in those who were vaccinated aged 12 to 13. We expect these results to also be reflected in other UK nations.

The vaccine is most effective when given between the ages of 11 and 13 when someone is less likely to have been exposed to HPV.

Different types of HPV Vaccine:

There are various forms of the HPV vaccine that protect against different HPV strains:

  • Quadrivalent vaccine (Gardasil): Protects again 4 types of HPV – HPV 16 and 18, which together cause around 7 in 10 cervical cancer cases in the UK, and HPV 6 and 11, which cause most genital warts. This is the vaccine available in the UK to all children aged 11 to 13 and was the vaccine used in this study.
  • Bivalent vaccine (Cervarix): Protects against HPV 16 and 18, has the equivalent cancer-prevent properties as the quadrivalent vaccine.
  • Nonvalent vaccine: (Gardasil 9): Protects against 9 types of HPV, including types 31, 33, 45, 52 and 58, as well as the HPV types mentioned above.

Since 2008, girls aged 11 to 13 in the UK have been offered the vaccine and since September 2019, boys of the same age can also get it. Anyone who missed their vaccine can request it through the NHS up to the age of 25.

Professor Peter Sasieni, lead author from King’s College London, says: “It’s been incredible to see the impact of HPV vaccination, and now we can prove it prevented hundreds of women from developing cancer in England. We’ve known for many years that HPV vaccination is very effective in preventing particular strains of the virus, but to see the real-life impact of the vaccine has been truly rewarding.

“Assuming most people continue to get the HPV vaccine and go for screening, cervical cancer will become a rare disease. This year we have already seen the power of vaccines in controlling the COVID-19 pandemic. These data show that vaccination works in preventing some cancers.”

The virus is also linked to other cancers, including vaginal, vulval, anal, penile and some head and neck cancers.

Dr Vanessa Saliba, Consultant Epidemiologist for UKHSA, said: “These remarkable findings confirm that the HPV vaccine saves lives by dramatically reducing cervical cancer rates among women. This reminds us that vaccines are one of the most important tools we have to help us live longer, healthier lives.”

Keeping up momentum

Cancer Research UK is also funding research to ensure more people globally are able to be fully vaccinated against HPV. Cancer Research UK is proud to be co-funding — with the Bill & Melinda Gates Foundation and the National Cancer Institute — the PRIMAVERA trial in Costa Rica. The trial tests the protective immunity of a single dose of the HPV vaccine. We also fund advocacy and policy research in low- and middle-income countries to ensure that, through increased access and uptake in HPV vaccination, a future without cervical cancer can be a reality for people all over the world.

“This fantastic achievement has been made possible thanks to the high uptake of the HPV vaccine in England. We encourage all who are eligible for the HPV vaccine to take it up when it is offered in school. All those eligible can catch-up until their 25th birthday. Together with cervical screening, this will help to protect more women from preventable cases of cervical cancer,” said Saliba.


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