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Abnormalities detected in cervical cancer screening fall as HPV vaccine makes impact

Study showing 60 per cent drop in detections of pre-cancers suggests Ireland on way to eliminating the disease

The percentage of cervical screening tests showing serious pre-cancer disease in 25-year-old women fell from 3.7 per cent before the introduction of HPV vaccination to 1.5 per cent after, a study shows. Photograph: David Davies/PA Wire
The percentage of cervical screening tests showing serious pre-cancer disease in 25-year-old women fell from 3.7 per cent before the introduction of HPV vaccination to 1.5 per cent after, a study shows. Photograph: David Davies/PA Wire

Diagnoses of serious abnormalities in cervical screening have fallen by almost 60 per cent, in early evidence of the positive impact of HPV vaccination against the disease.

The percentage of cervical screening tests showing serious pre-cancer disease in 25-year-old women fell from 3.7 per cent before the introduction of HPV vaccination to 1.5 per cent after, a study shows.

In the study, published in the Irish Journal of Medical Science, researchers used anonymised data from CervicalCheck and plotted these against vaccination rates after the HPV programme was rolled out from 2010 for 12-13-year-old girls in the first year of secondary school. A catch-up programme was offered to older girls, but had a lower uptake.

The cohort of girls provided with HPV vaccines first became eligible for cervical cancer screening at age 25 in 2019.

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The rate of high-grade abnormalities rose initially, from 2.7 per cent to 4.6 per cent from 2010 to 2014, “reflective of the initial increase expected of a new screening programme”, the study found.

It then fell to 2.3 per cent in 2019, and more steeply to 1 per cent in 2022.

The rate in 25-year-old women was 3.7 per cent of all cytology tests in this age group for 2015-2018, and 1.5 per cent for 2019-2022.

The study gives an early indication of the impact of HPV vaccination, the authors say, and adds to the growing international evidence that a combination of screening and HPV vaccination can lead to the elimination of cervical cancer.

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Initial vaccination rates of catch-up groups were low, so it is expected that as the cohorts with higher uptakes become eligible for screening, HPV vaccination will exercise an even more protective effect.

The uptake of HPV vaccination was high initially but fell after an online campaign of opposition, based on inaccurate information about safety. It has since partially recovered.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.