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Since the introduction of the HPV vaccination programme for school girls in 2008 (extended to boys in 2019), a high vaccine coverage (80%–90%) has led to significant reductions in CIN3 and cervical cancer in England (by 97% and 87%, respectively).1 Since 2014, there has also been a substantial and sustained reduction in the incidence of anogenital warts (AGW), likely attributable to the change from the bivalent (Cervarix) to the quadrivalent (Gardasil-4) HPV vaccine in the school-based programme.2 The most marked decline has been described in females aged 15–17, in whom the incidence of first-episode AGW was 95% lower in 2020 compared with that in 2016.3
While HPV vaccination is highly effective in the prevention of HPV infection in those without prior exposure, its ability to impact on established HPV infection and HPV-related disease remains unclear. The HIPvac trial did not show a benefit of Gardasil-4 (vs placebo) when added to topical therapy …
Footnotes
Twitter @drjakebayley
Contributors Column was written and reviewed by both JB and DN.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
↵Anal Cancer HSIL Outcomes Research
↵Screening and Early Detection to Prevent Anal Cancer