Examining the effectiveness of laws requiring human papillomavirus vaccination on cervical cancer rates.

Abstract

e17533 Background: Cervical cancer is a significant global health challenge and ranks as the fourth most common cancer in women worldwide. Human Papillomavirus (HPV) vaccination is effective in preventing HPV infection, the primary cause of cervical cancer. To prevent HPV infection, five jurisdictions in the United States passed laws requiring HPV vaccination for school attendance: Virginia and Washington, D.C. in 2007, Rhode Island in 2015, Puerto Rico in 2017, and Hawaii in 2019. This study is the first to evaluate the association between these HPV vaccination laws and changes in cervical cancer incidence rates. Methods: This study is a retrospective, observational analysis. State Cancer Profiles from the National Cancer Institute and Centers for Disease Control and Prevention were used to compare cervical cancer incidence rates in Virginia, Washington, D.C., Rhode Island, Hawaii, and Puerto Rico to the rest of the United States from 2002 to 2021. Linear regression models were developed for each jurisdiction using MATLAB to evaluate changes in incidence rates before and after implementing HPV vaccination laws. Statistical significance was defined as a p-value < 0.05. Results: Virginia (p=0.04) and Puerto Rico (p=0.04) demonstrated significant decreases in cervical cancer incidence rates following the implementation of HPV vaccination laws. However, no significant changes were observed in Washington, D.C., Rhode Island, or Hawaii. Nationwide, the incidence rate of cervical cancer also showed a significant decreasing trend during the study period. Conclusions: This study provides preliminary evidence that HPV vaccination laws may contribute to reduced cervical cancer incidence rates, as seen in Virginia and Puerto Rico. However, similar effects were not observed in Washington, D.C., Rhode Island, or Hawaii. It remains unclear whether these state laws directly led to significant decreases in cervical cancer rates, given the nationwide decline in cervical cancer incidence during the same period. Limitations include the small number of jurisdictions with HPV vaccination laws and the short time frame available for post-legislation analysis. These findings may serve as an early indicator of the efficacy of HPV vaccine laws in reducing cervical cancer incidence, underscoring the need for extended longitudinal studies to evaluate their long-term impact.