# England's HPV programme: cervical cancer down 87% in the first cohort vaccinated at 12-13

Source: https://onco.cc/key-papers/paper-hpv-vaccine-england-lancet-2021/  
OnCo record `paper-hpv-vaccine-england-lancet-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Ten years after England began vaccinating 12- to 13-year-olds with the bivalent HPV vaccine, cervical cancer in that cohort had fallen by 87% and severe precancer (CIN3) by 97%.

## Summary

A population-based observational study used English cancer registry data from 2006 to 2019 to compare cervical cancer and CIN3 rates in cohorts offered the bivalent vaccine (Cervarix) at ages 12-13, 14-16 and 16-18 with earlier, unvaccinated cohorts, adjusting for changes in screening.

Relative reductions in cervical cancer were 87% in the cohort offered vaccination at 12-13, 62% at 14-16 and 34% at 16-18. CIN3 fell by 97%, 75% and 39% respectively. The authors estimated about 450 fewer cervical cancers and 17,200 fewer CIN3 cases by mid-2019.

This confirmed the Swedish finding with a different vaccine and a school-based programme with high coverage.

## Fields

- Kind: Key paper
- Last checked: 2026-09-08
- Journal: The Lancet
- Year: 2021
- DOI: 10.1016/S0140-6736(21)02178-4
- Authors: Falcaro M, Castañon A, Ndlela B, et al.
- Findings: Cervical cancer reduced 87% (95% CI 72-94) in the cohort offered vaccine at age 12-13; Reduction of 62% (52-71) at 14-16 and 34% (25-41) at 16-18; CIN3 reduced 97% (96-98) in the youngest cohort; An estimated 448 fewer cervical cancers and 17,235 fewer CIN3 cases by June 2019
- What it means: School-based vaccination at 12-13 with high uptake nearly abolishes cervical cancer in vaccinated cohorts, even with a vaccine covering only two HPV types. Screening intervals and the future of cervical screening can now be redesigned around vaccination status.
- Caveats: Observational with a cohort comparison; changes in screening policy were adjusted for but cannot be fully excluded; Vaccinated cohorts were still young (under 28), so absolute numbers of cancers were small; Bivalent vaccine; England later switched to quadrivalent and nonavalent; Effects in populations with lower coverage will be smaller

## Sources

- DOI: https://doi.org/10.1016/S0140-6736(21)02178-4

## Connected records

- key papers: [Swedish registry study: HPV vaccination almost eliminates cervical cancer when given before 17](https://onco.cc/key-papers/paper-hpv-vaccine-sweden-nejm-2020/)
- ideas: [Catch-up HPV vaccination for men to prevent throat cancer](https://onco.cc/ideas/idea-prev-hpv-male-catchup-oropharynx/), [Offer HPV vaccination to women when they come for cervical screening or treatment](https://onco.cc/ideas/idea-prev-hpv-vaccinate-at-screening/)
- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/)
- fronts: [Prevention & Risk](https://onco.cc/fronts/prevention/)
- technologies: [HPV & HBV vaccination](https://onco.cc/technologies/hpv-vaccine/), [HPV DNA testing and self-sampling](https://onco.cc/technologies/hpv-testing/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prevention we already have is not deployed](https://onco.cc/bottlenecks/b-prevention-adoption/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)
- people: [Peter Sasieni](https://onco.cc/people/peter-sasieni/)
- collections: [NHS HPV vaccination programme](https://onco.cc/collections/nhs-hpv-vaccination/)

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