A national HPV vaccination programme in England has been associated with a dramatic reduction in cervical cancer deaths among young women, with researchers reporting that no cervical cancer deaths occurred among women aged 20–24 years between 2020 and 2024 despite more than 23 deaths being expected based on historical trends.

The findings, published in The Lancet, provide what researchers describe as the strongest evidence to date that widespread HPV vaccination is not only preventing cervical cancer but also saving lives.

“Our findings provide the first robust national-level evidence, albeit observational, that high HPV vaccination coverage is associated with a substantial reduction in cervical cancer deaths,” the authors wrote.

“This is shown by the substantial decrease in cervical cancer deaths observed among women aged 20–29 years in England, particularly among those vaccinated at ages 12–13 years.”

The researchers added: “These findings support the achievability of the WHO goal of eliminating cervical cancer as a public health problem, and efforts should be made to achieve high vaccine uptake among young adolescents globally.”

No deaths where 23 were expected

The study analysed population-based cervical cancer mortality data in England from 2001 to 2024 among women aged 20–24, 25–29 and 30–34 years.

England introduced a school-based HPV vaccination programme in 2008 for girls aged 12–13 years, followed by a catch-up campaign for girls aged 14–18 years. Before the COVID-19 pandemic, vaccination coverage in the routine programme reached around 80–90%.

Among women aged 20–24 years between 2020 and 2024—most of whom had received the vaccine at ages 12–13 years with vaccination coverage of around 88–90%—the researchers found no cervical cancer deaths.

This compared with 23.1 expected deaths based on historical mortality rates, representing a 100% reduction in mortality (95% confidence interval 84–100).

The study also reported an 80% reduction in cervical cancer mortality among women aged 20–24 years during 2015–2019 and a 69% reduction among women aged 25–29 years during 2020–2024.

Using statistical modelling, the researchers estimated that vaccination reduced the risk of cervical cancer death by 100% among vaccinated women aged 20–24 years, 100% among those aged 25–29 years, and 63% among women aged 30–34 years, although the latter estimate had wider uncertainty because relatively few deaths occurred.

Overall, the study estimated that HPV vaccination in England had prevented around 200 cervical cancer deaths by the end of 2024.

First evidence on mortality

The authors noted that while several countries have already documented sharp declines in cervical cancer incidence following HPV vaccination, evidence on mortality has been limited.

“Several countries have reported substantial falls in cervical cancer incidence following HPV vaccination, but there is little evidence of the effect of HPV vaccination on cervical cancer mortality,” they wrote.

The study therefore aimed “to investigate trends in cervical cancer mortality and to estimate the reduction in cervical cancer deaths in young women in England following the introduction of HPV vaccination.”

Researchers analysed national mortality records alongside vaccination coverage by birth cohort. They estimated the proportion of women vaccinated in each age group and year, then compared observed deaths with those expected had vaccination not been introduced.

Built on high vaccine coverage

The researchers attributed the success largely to England’s high vaccination uptake.

“A school-based HPV vaccination programme has been in place in England since September, 2008,” they wrote.

“The routine programme targets girls aged 12–13 years, with boys of the same age included since 2019.”

The authors noted that “the high vaccination coverage (of around 90% for one dose before the COVID-19 pandemic) resulted in a large decrease of up to 87% in cervical cancer incidence in cohorts targeted by vaccination, particularly in those targeted before age 16 years.”

Until now, however, “the effect of vaccination on cervical cancer mortality has not been empirically assessed,” they said.

Conservative estimates

The researchers said the observed reductions may actually underestimate the vaccine’s impact.

“Notably, there were no deaths from cervical cancer in women aged 20–24 years in 2020–24, compared with 23.1 expected deaths based on the average rate… observed between 2000 and 2014—a reduction in cervical cancer mortality of 100%.”

They added that “since a proportion of women aged 20–24 years in 2010–14 will have been vaccinated—a mean of 24%—these descriptive reductions are conservative.”

Global implications

The findings strengthen the case for expanding HPV vaccination worldwide as countries pursue the World Health Organization’s cervical cancer elimination strategy.

As the researchers concluded: “These findings support the achievability of the WHO goal of eliminating cervical cancer as a public health problem, and efforts should be made to achieve high vaccine uptake among young adolescents globally.”

With nearly 150 countries now including HPV vaccination in their national immunisation programmes, the English experience offers compelling real-world evidence that high vaccine coverage can translate into lives saved—not just cancers prevented.

Also read: HPV vaccine cuts precancer risk by over 50 per cent when given early, study finds