Evidence map›Paper›PMID 34741816›Full record

Observational studyLancet (London, England)2021

The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study.

Milena Falcaro, Alejandra Castañon, Busani Ndlela, Marta Checchi, Kate Soldan, Jamie Lopez-Bernal, Lucy Elliss-Brookes, Peter Sasieni

3 registry-linked trialsAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Lancet (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 408 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
408citing papers in PubMed, 13 pooled it
75.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06227689 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Evaluation of Vaccine Chatbot on HPV Vaccine Awareness and Vaccination for Middle School Girls in China: a Randomized Controlled Trial and Implementation Science Study

TypeinterventionalSponsorFudan UniversityRan2024 to 2024Enrolled1,800ConditionsHPV VaccineArmsVaccine chatbot that offering HPV vaccine-related information
NCT07200570 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Evaluation of a Vaccine Chatbot on HPV Vaccine Confidence and Hesitancy: a Randomized Controlled Trial and Implementation Science Study

TypeinterventionalSponsorFudan UniversityRan2026 to 2026Enrolled1,800ConditionsHPV VaccineArmsLLM-Powered HPV Vaccine Chatbot
NCT07637630 narecruitingnot on this mapstarted 2026, after this paper: background citation

Applying the Multiphase Optimization Strategy to Develop and Test a Culturally-Relevant Digital Health Intervention Targeting HPV Vaccination Among U.S. Vietnamese

TypeinterventionalSponsorNorthwestern UniversityRan2026 to 2029Enrolled96ConditionsHPV-related Cancers, HPV VaccinationArmsExpert Video, Self-persuasion, Narrative Storytelling, Motivational Interviewing, Constant Component
3 · Its place in the literature

Who cites it

408 citing papers in PubMed, 13 syntheses or guidelines pooled it, 710 citations in OpenAlex.

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348 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Milena FalcaroCancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Alejandra CastañonCancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Busani NdlelaNational Cancer Registration and Analysis Service, Public Health England, Manchester, UK.
Marta ChecchiBlood Safety, Hepatitis, Sexually Transmitted Infections and HIV Service, National Infection Service, Public Health England, London, UK.
Kate SoldanBlood Safety, Hepatitis, Sexually Transmitted Infections and HIV Service, National Infection Service, Public Health England, London, UK.
Jamie Lopez-BernalImmunisations and Countermeasures Division, Public Health England, London, UK.
Lucy Elliss-BrookesNational Cancer Registration and Analysis Service, Public Health England, London, UK.
Peter SasieniCancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK; Innovation Hub, Guy's Cancer Centre, Guy's Hospital, London, UK. Electronic address: peter.sasieni@kcl.ac.uk.
Public Health England · GBGuy's Hospital · GBKing's College London · GBLondon Cancer · GB

Funding

Cancer Research UK 25356Cancer Research UK 27047
6 · The paper itself

Abstract

backgroundHuman papillomavirus (HPV) immunisation with a bivalent vaccine (Cervarix) was introduced in England, UK, in Sept 1, 2008: routine vaccination was offered to girls aged 12-13 years with a catch-up programme for females aged 14-18 years in 2008-10. We quantified the early effect of this immunisation programme on cervical cancer and cervical carcinoma in situ, namely grade 3 cervical intraepithelial neoplasia (CIN3), registrations.

methodsIn this observational study, we used an extension of the age-period-cohort Poisson model to estimate the relative risk of cervical cancer in three vaccinated cohorts compared with earlier cohorts that were not eligible for HPV vaccination. Data from a population-based cancer registry were extracted on Jan 26, 2021, and were assessed for diagnoses of cervical cancer and CIN3 from Jan 1, 2006 to June 30, 2019 in women aged 20-64 years and who were a resident in England. We used three vaccinated cohorts to account for differences in the school year in which the vaccine was offered and its national coverage. Adjustment for confounding was made using information on changes in cervical screening policy and historical events that affected cervical cancer incidence. Results were compared across models with different adjustments for confounders.

findingsWe used data from a total of 13·7 million-years of follow-up of women aged 20 years to younger than 30 years. The estimated relative reduction in cervical cancer rates by age at vaccine offer were 34% (95% CI 25-41) for age 16-18 years (school year 12-13), 62% (52-71) for age 14-16 years (school year 10-11), and 87% (72-94) for age 12-13 years (school year 8), compared with the reference unvaccinated cohort. The corresponding risk reductions for CIN3 were 39% (95% CI 36-41) for those offered at age 16-18 years, 75% (72-77) for age 14-16 years, and 97% (96-98) for age 12-13 years. These results remained similar across models. We estimated that by June 30, 2019 there had been 448 (339-556) fewer than expected cervical cancers and 17 235 (15 919-18 552) fewer than expected cases of CIN3 in vaccinated cohorts in England.

interpretationWe observed a substantial reduction in cervical cancer and incidence of CIN3 in young women after the introduction of the HPV immunisation programme in England, especially in individuals who were offered the vaccine at age 12-13 years. The HPV immunisation programme has successfully almost eliminated cervical cancer in women born since Sept 1, 1995.

fundingCancer Research UK.

Indexed as

Early Detection of CancerIncidenceAdolescentAdultChildEnglandFemaleHumansImmunizationMiddle AgedPapillomavirus InfectionsPapillomavirus VaccinesRegistriesUterine Cervical DysplasiaUterine Cervical NeoplasmsVaccinationhuman papillomavirus vaccine, L1 type 16, 18Papillomavirus Vaccines

Identifiers

PMID34741816
OpenAlexW3209481766

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.