HPV Vaccination Associated With Zero Cervical Cancer Deaths in England's Highest-Coverage Birth Cohort, Lancet Study Finds

A population-level study published in The Lancet on June 19, 2026, has found zero cervical cancer deaths among women in England’s highest-coverage HPV-vaccinated birth cohort over a five-year follow-up window — the first evidence that HPV vaccination can drive cervical cancer mortality to zero in a real-world national cohort.

The study, led by Peter Sasieni (Wolfson Institute of Population Health, Queen Mary University of London) and Alejandra Falcaro, tracked cervical cancer mortality in English women by birth cohort according to the timing and coverage of the NHS HPV vaccination program launched in 2008. Among the cohort with vaccine coverage of 88–90% — those who received the jab through the school-based program at ages 12–13 — no cervical cancer deaths were recorded during the five-year observation window (women aged 20–24 in 2020–24). The authors report an 80% reduction in cervical cancer mortality in women aged 20–24 in 2015–19 (a period capturing the first routinely vaccinated cohorts as well as catch-up recipients), and a 69% reduction among women aged 25–29 in 2020–24, each compared with modelled expected mortality in the absence of vaccination.

What the evidence shows — and what it does not

The zero-mortality finding in the highest-coverage cohort represents a landmark in the epidemiology of vaccine-preventable cancer. Prior evidence from Scotland and Sweden had demonstrated near-elimination of HPV-16/18-associated cervical intraepithelial neoplasia (CIN2+) in vaccinated cohorts, and multiple countries reported falling incidence rates. England’s national cohort study, spanning the NHS cervical screening programme and the ONS death registry, now adds mortality as an endpoint — the hardest clinical signal in cancer epidemiology.

The authors are careful to note that the zero-death finding applies to the highest-coverage birth cohort at the ages studied (early-to-mid thirties), during a five-year window. The absence of deaths does not constitute proof of elimination across all ages or all HPV-associated cancers; follow-up will be required as the cohort ages into the decade of peak cervical cancer incidence. The comparison with unvaccinated historical controls also carries the assumptions inherent in such designs.

Cervical cancer caused by HPV types 16 and 18 — the two strains targeted by all licensed HPV vaccines, and by the bivalent Cervarix vaccine initially offered in England — accounts for approximately 70% of cervical cancer burden. Types not targeted by the original bivalent vaccine (31, 33, 45, 52, 58) account for a further 20%. England began offering the nonavalent Gardasil 9 (covering nine HPV types) in 2021, which should broaden coverage going forward.

England’s HPV vaccination programme

The NHS launched the national HPV immunisation programme in September 2008, offering two doses of Cervarix to girls in Year 8 (ages 12–13), with a catch-up programme extended to girls aged up to 18. England switched to Gardasil 4 in 2012, and then to Gardasil 9 in 2021. The programme was extended to boys in 2019. Coverage in the primary cohort (Year 8 girls) reached 80–90% in the early years of the programme and has been sustained above 85% in most years since, making England one of the highest-coverage national programmes in Europe.

The Lancet analysis translates that coverage into a mortality outcome for the first time at national scale.

Global implications

Cervical cancer remains the fourth most common cancer in women worldwide, responsible for approximately 350,000 deaths annually — the large majority in low- and middle-income countries where HPV vaccination coverage and cervical screening remain limited. The England result will reinforce advocacy for high-coverage national programmes in settings where both are available. It also provides a mortality endpoint for the mathematical models used to estimate the benefit-cost ratio of vaccination programmes.

WHO’s 2030 targets for cervical cancer elimination — 90% of girls vaccinated by age 15, 70% of women screened by age 35 and 45, and 90% of women identified with disease treated — require substantial scale-up. The England data add urgency to that agenda.

Sasieni P, Falcaro A, et al. “HPV vaccination and cervical cancer mortality in England: a population cohort study.” The Lancet. 2026. DOI: 10.1016/S0140-6736(26)00918-9. PMID: 42309117.

Correction (2026-06-19): Two errors corrected by post-publication fact-check. (1) Lead author Peter Sasieni’s institution was listed as King’s College London; the Lancet paper (PMID 42309117) lists his affiliation as the Wolfson Institute of Population Health, Queen Mary University of London. (2) The 80% cervical cancer mortality reduction was attributed to “catch-up vaccination cohorts”; the source assigns this figure to women aged 20–24 in 2015–19 — an age-period cell that includes both routine and catch-up vaccinees, not catch-up recipients exclusively. The comparator for both figures is modelled expected mortality in the absence of vaccination, not unvaccinated historical controls per se.