The human papillomavirus virus (HPV) vaccine was licensed and recommended for use in the United States and many other countries in 2006. This recommendation was based on studies showing that HPV4, which included serotypes 6, 11, 16 and 18, prevented precancerous cervical lesions (i.e., cervical intraepithelial neoplasia grade 2 [CIN2] or grade 3 [CIN3]). Because CIN2 and CIN3 are requisite stages to the development of cervical cancer, it was assumed that long-term studies would eventually show that the HPV vaccine would dramatically decrease the incidence of cervical cancer. However, because of the long lead time from HPV infection to the development of cervical cancer and the low risk of cervical cancer after vaccination, these studies were not immediately available.

This month, researchers from the Karolinska Institute in Sweden, using national registry data, published a study of 1,672,983 girls and women 10 to 30 years of age followed from 2006 to 2017 (Lei, JA, Ploner, Elfström, KM, et al. HPV vaccination and the risk of cervical cancer. N Engl J Med. 2020 Oct 1;383(14):1340-1348). Cervical cancer was diagnosed in 19 women who had received the quadrivalent HPV vaccine and in 538 women who had not received the vaccine. The authors concluded, “Among Swedish girls and women 10 to 30 years old, quadrivalent HPV vaccination was associated with a substantially reduced risk of invasive cervical cancer at the population level.” This study offers yet more evidence of the critical importance of this vaccine.

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