HPV vaccine protects females against several cancers

Immunization against the human papillomavirus (HPV) can reduce the incidence of various cancer types in females 9 to 26 years of age, according to a study.

“Our real-world investigation, employing electronic health records from numerous US centres, has unveiled a significant association between HPV vaccination and a lower incidence of multiple cancer categories among females aged 9‒26,” the investigators said. “This association remains consistent across diverse age groups, racial backgrounds, and vaccine types.”

This retrospective cohort study used the TriNetX US Collaborative Network (1 January 2013 to 31 December 2022) and compared HPV-vaccinated with unvaccinated females after 1:1 propensity score matching. The investigators used Cox proportional hazards models to estimate hazard ratios (HRs), with subgroup analyses by age, race/ethnicity, and vaccine valence.

Finally, sensitivity analyses were conducted using active comparators (influenza- and HBV-vaccinated) and a health check-up cohort.

HPV vaccination resulted in a significant reduction in overall cancer risk (HR, 0.38, 95 percent confidence interval [CI], 0.34‒0.42), with greater reduction when initiated at aged 9‒14 vs 15‒26 years (HR, 0.37 vs 0.54). [Am J Med 2026;139:311-320.e12]

Furthermore, both the 9vHPV and 4vHPV vaccines significantly reduced cancer risks, with 9vHPV conferring greater protection, except for respiratory and intrathoracic cancers. This finding persisted in sensitivity analyses.

“Our findings are consistent with the existing recommendations that encourage early, on-time vaccination and series completion, while further research with extended follow-up is needed to attain a full-scale apprehension of the potential protective association,” the investigators said.

Early vaccination

The findings also align with UK population data showing greater benefits with early vaccination and strengthening the role of reminder‒recall and co-administration at well-child visits. [J Infect Chemother 2014;20:741-747]

Despite this, uptake remains poor among high-risk individuals, such as young cancer survivors, among whom only 24 percent initiated and 13.5 percent completed HPV vaccination. [J Clin Oncol 2017;35:3582-3590]

Furthermore, previous studies on oropharyngeal cancer report lower oral HPV prevalence among vaccinated patients. [PLoS One 2013;8:e68329; J Clin Oncol 2018;36:262-267]

“Our cohort-level association (HR, 0.21) is directionally consistent with those data and supports consideration of policies to increase coverage, which may help reduce HPV-attributable oropharyngeal cancers at the population level,” the investigators said.

Cancer prevention

Earlier trials have also shown evidence linking HPV infection with the development of several cancers, such as those of the urinary tract, breast cancer, brain and nervous system, digestive organ, respiratory and intrathoracic organ, and melanoma and other skin cancers, among others. [Ann Clin Anal Med 2021;12:353-357; Front Oncol 2023;13:1210381; Neuro Oncol 2014;16:298-302; Neuro Oncol 2014;16:298-302; Biology (Basel) 2022;11:1691; Biology (Basel) 2022;11:1691]

“The introduction of routine HPV vaccination among adolescents and young adults has resulted in a notable reduction in the prevalence of HPV infection and associated diseases, including female genital cancers and oropharyngeal cancers,” the investigators said. [Lancet 2009;374:301; Cochrane Database Syst Rev 2018;5:CD009069]

“The FDA’s approval of the Quadrivalent HPV(4vHPV) vaccine in 2006 for females aged 9‒26, followed by the approval of the bivalent HPV vaccine for females aged 9‒25 in 2009, marked a significant milestone in this endeavour,” they added.