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Clinical Review State of the Art Review

Human papillomavirus vaccination and cervical cancer risk

BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2022-070115 (Published 15 December 2022) Cite this as: BMJ 2022;379:e070115

This article has a correction. Please see:

  1. Lisa Rahangdale, professor1 2 3,
  2. Chemtai Mungo, assistant professor1 2 3,
  3. Siobhan O’Connor, associate professor4,
  4. Carla J Chibwesha, associate professor1 5,
  5. Noel T Brewer, Gillings distinguished professor2 6
  1. 1Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
  2. 2Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
  3. 3Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
  4. 4Department of Pathology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
  5. 5Clinical HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
  6. 6Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
  1. Correspondence to: L Rahangdale lisa_rahangdale{at}med.unc.edu

ABSTRACT

Persistent human papillomavirus infection is the central cause of cervical cancer, the leading cause of cancer death among women worldwide. Clear evidence from both randomized trials and population based studies shows that vaccination against human papillomavirus reduces the incidence of cervical pre-cancer. These data suggest that the vaccine reduces the incidence of cervical cancer. However, human papillomavirus vaccine coverage is inadequate in all countries, especially in low and middle income countries where disease burden is highest. Supply side strategies to improve coverage include increasing the availability of low cost vaccines, school located delivery, single dose vaccine schedules, and development of vaccines that do not need refrigeration. Demand side strategies include enhancing provider recommendations, correcting misinformation, and public awareness campaigns. The near elimination of cervical cancer is achievable through increased uptake of human papillomavirus vaccination and efforts to increase screening for cervical cancer, especially when enacted to reduce disparities in across the world.

Footnotes

  • Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors

  • Contributors: LR had the idea for the article, did the literature search, and led the writing of the manuscript. CM, SO, CJC, and NTB contributed to the writing of the manuscript. LR is the guarantor.

  • Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: LR has received research funding on antiretroviral therapy from Merck and Co, Inc; CC has been awarded the Merck HPV Investigator Studies Program (MISP) for cervical cancer prevention research; NB has served as a paid adviser on vaccine behavior research to the Centers for Disease Control and Prevention, World Health Organization, Merck and Co, Inc, Novartis, and Sanofi.

  • Provenance and peer review: Commissioned; externally peer reviewed.

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