ArticleBMJ (Clinical research ed.)2019
Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study.
Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 114 papers, 8 of them syntheses that pooled it.
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Who cites it
114 citing papers in PubMed, 8 syntheses or guidelines pooled it, 236 citations in OpenAlex.
- Maximizing impact: the power of early HPV vaccination for long-term protection-lessons from a systematic review and meta-regression analysis.Journal of public health (Oxford, England) · 2026Pooled it
- Immunogenicity, efficacy, and safety of different dose schedules of human papillomavirus vaccines: a Bayesian network meta-analysis of randomized controlled trials.Frontiers in immunology · 2026Pooled it
- Effects of human papillomavirus (HPV) vaccination programmes on community rates of HPV-related disease and harms from vaccination.The Cochrane database of systematic reviews · 2025Pooled it
- Human papillomavirus vaccine effectiveness by age at vaccination: A systematic review.Human vaccines & immunotherapeutics · 2023Pooled it
- Pooled it
- HPV vaccination among seropositive, DNA negative cohorts: a systematic review & meta-analysis.Journal of gynecologic oncology · 2022Pooled it
- Risk of Guillain-Barré syndrome after vaccination against human papillomavirus: a systematic review and meta-analysis, 1 January 2000 to 4 April 2020.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2022Pooled it
- Interventions targeted at women to encourage the uptake of cervical screening.The Cochrane database of systematic reviews · 2021Pooled it
- Controlled trial of cervical cancer screening frequency among human-papillomavirus-vaccinated women.International journal of cancer · 2026Trial
- Effectiveness of SMS reminders to increase demand for HPV immunisation: a randomised controlled trial in Georgia.BMJ open · 2025Trial
- Effectiveness of various human papillomavirus vaccination strategies: A community randomized trial in Finland.Cancer medicine · 2021Trial
- Long-term persistence of immune response to the AS04-adjuvanted HPV-16/18 vaccine in Chinese girls aged 9-17 years: Results from an 8-9-year follow-up phase III open-label study.Asia-Pacific journal of clinical oncology · 2020Trial
- Efficacy of the bivalent HPV vaccine against HPV 16/18-associated precancer: long-term follow-up results from the Costa Rica Vaccine Trial.The Lancet. Oncology · 2020Trial
- Early effects of HPV vaccination on high-grade cervical intraepithelial neoplasia in Brazil: Evidence from outpatient data.Human vaccines & immunotherapeutics · 2026Article
- HPV vaccine awareness and uptake among women attending cervical screening in health-resource-limited areas of China: A multicenter cross-sectional study.Human vaccines & immunotherapeutics · 2026Article
- Population-Based First Estimates of the Effect of HPV Vaccination in Three Italian Areas Covered by Organised Cervical Screening.International journal of cancer · 2026Article
- How to evaluate and select cervical screening and triage tests in vaccinated populations.Journal of the National Cancer Institute. Monographs · 2026Article
- Real-world Impact of HPV Vaccination on CIN2+ Reduction: A Meta-analysis of Observational Studies Assessing Variation by Age, Coverage, and Vaccine Type.Open forum infectious diseases · 2026Review
- Effect of prophylactic HPV vaccination and timing of administration on recurrence of cervical HSIL after LEEP: A retrospective study.Medicine · 2026Article
- Comment on: Introduction of the HPV Vaccine among Young Girls to Reduce the Long-Term Risk of Cervical Cancer in Eswatini.Asian Pacific journal of cancer prevention : APJCP · 2026Article
54 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo quantify the effect on cervical disease at age 20 years of immunisation with bivalent human papillomavirus (HPV) vaccine at age 12-13 years.
designRetrospective population study, 1988-96.
settingNational vaccination and cervical screening programmes in Scotland.
participants138 692 women born between 1 January 1988 and 5 June 1996 and who had a smear test result recorded at age 20.
main outcome measuresEffect of vaccination on cytology results and associated histological diagnoses from first year of screening (while aged 20), calculated using logistic regression.
results138 692 records were retrieved. Compared with unvaccinated women born in 1988, vaccinated women born in 1995 and 1996 showed an 89% reduction (95% confidence interval 81% to 94%) in prevalent cervical intraepithelial neoplasia (CIN) grade 3 or worse (from 0.59% (0.48% to 0.71%) to 0.06% (0.04% to 0.11%)), an 88% reduction (83% to 92%) in CIN grade 2 or worse (from 1.44% (1.28% to 1.63%) to 0.17% (0.12% to 0.24%)), and a 79% reduction (69% to 86%) in CIN grade 1 (from 0.69% (0.58% to 0.63%) to 0.15% (0.10% to 0.21%)). Younger age at immunisation was associated with increasing vaccine effectiveness: 86% (75% to 92%) for CIN grade 3 or worse for women vaccinated at age 12-13 compared with 51% (28% to 66%) for women vaccinated at age 17. Evidence of herd protection against high grade cervical disease was found in unvaccinated girls in the 1995 and 1996 cohorts.
conclusionsRoutine vaccination of girls aged 12-13 years with the bivalent HPV vaccine in Scotland has led to a dramatic reduction in preinvasive cervical disease. Evidence of clinically relevant herd protection is apparent in unvaccinated women. These data are consistent with the reduced prevalence of high risk HPV in Scotland. The bivalent vaccine is confirmed as being highly effective vaccine and should greatly reduce the incidence of cervical cancer. The findings will need to be considered by cervical cancer prevention programmes worldwide.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.