Cervical cancer mortality trends following HPV vaccination in England, 2001–24: an analysis of population-based mortality data
High adolescent human papillomavirus vaccination coverage was associated with major reductions in cervical cancer deaths in young women.
*Population-based observational trend analysis; Level 2c.
Citation
Sasieni P, Falcaro M. Cervical cancer mortality trends following HPV vaccination in England, 2001–24. Lancet. 2026;408:162-168. doi:10.1016/S0140-6736(26)00918-9
Background
Human papillomavirus vaccination reduces cervical cancer diagnoses, but evidence that it reduces deaths has been limited. England introduced routine school vaccination for girls aged 12–13 years in 2008, with a catch-up program for ages 14–18 years.
Patients
Women in England aged 20–34 years with national cervical cancer mortality data from 2001–2024. Data were public and de-identified; individual vaccination status, race, and ethnicity were unavailable.
Intervention
Population-level human papillomavirus vaccination, mainly during adolescence.
Control
Expected cervical cancer deaths based on historical mortality patterns without vaccination.
Outcome
Cervical cancer mortality and estimated deaths prevented.
Follow-up Period
National mortality trends from 2001 through 2024.
Results
| Group | Key finding | Mortality reduction |
|---|---|---|
| Age 20–24 years, 2020–2024 | 0 deaths observed versus 23.1 expected | 100% (95% CI, 84–100) |
| Age 20–24 years, vaccinated estimate | High coverage at ages 12–13 years | 100% (95% CI, 81–100) |
| Age 25–29 years, vaccinated estimate | Earlier catch-up cohorts | 100% (95% CI, 89–100) |
| Age 30–34 years, vaccinated estimate | Vaccination often occurred later in adolescence | NS |
| All vaccinated cohorts through 2024 | Estimated cervical cancer deaths prevented | 199.6 (95% CI, 125.0–274.2) |
CI = confidence interval; NS = not statistically significant.
The control was modeled historical no-vaccination mortality, not a concurrent unvaccinated comparison group.
Limitations
This observational population study cannot prove causation. It used group-level vaccine coverage rather than individual vaccination records. Results depended on modeling assumptions, including no herd protection among unvaccinated women. Deaths were rare, especially in the youngest group, producing uncertainty. Data by race or ethnicity were unavailable.
Funding
Cancer Research UK; no funder role reported.
Clinical Application
Strongly reinforce routine adolescent human papillomavirus vaccination; prioritize high uptake before sexual exposure to prevent future cervical cancer deaths.
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