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HPV vaccine: high coverage could eradicate cervical cancer within decades, say researchers

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4450 (Published 27 June 2019) Cite this as: BMJ 2019;365:l4450

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Re: HPV vaccine: high coverage could eradicate cervical cancer within decades, say researchers

Dear editor,

We agree that high coverage is key to the eradication of cervical cancer, and reference Australia’s HPV vaccine programme as a leader in attempting to achieve this aim. Australia was the first country to introduce a nationwide HPV vaccination programme in 2007. It has amongst the lowest rates of cervical cancer worldwide and is on track to eliminate it in the next 20 years. [1]

Arguably, we cannot expect to completely eradicate HPV without also vaccinating boys. In Australia, the HPV vaccine has been offered to boys since 2013, and will be introduced to boys aged 11-12 years from September 2019 in the UK. Preceding this decision, there was controversy surrounding the cost-effectiveness and efficacy of introducing boys to the programme. Progress was slow with the decision originally promised in 2015. However, there is now more confidence that benefits will extend outside of cervical cancer to genital warts, and head and neck cancer. [2] It will therefore be interesting to see what effect this has in the long term goal of UK HPV eradication. Australia may be a good indicator of its success as they introduced the programme 6 years ahead of the UK.

Parent and sexual education are known key factors in vaccine uptake and HPV transmission respectively that must be maintained. The latter is particularly important, as no matter how great our coverage in the UK is able to achieve, immigration will continue to threaten this until world-wide eradication is achieved. This is likely far off with 85% of the global burden occurring in less developed regions.[3]

1. Hall M, Simms K, Lew J, Smith M, Brotherton J, Saville M et al. The projected timeframe until cervical cancer elimination in Australia: a modelling study. The Lancet Public Health. 2019;4(1):e19-e27.
2. HPV Action. Leading clinicians, scientists and academics in HPV urge Jeremy Hunt to expedite a decision to extend the national HPV vaccination programme to include all adolescent boys, protecting over 400 000 boys per year. 8 Jun 2016
3. Human papillomavirus (HPV) [Internet]. World Health Organization. 2019 [cited 8 July 2019]. Available from: https://www.who.int/immunization/diseases/hpv/en/

Competing interests: No competing interests

08 July 2019
Keira J Bralsford
Medical Student
Elias Jamieson
University of Manchester