ROUTINE vaccination of schoolgirls against the human papillomavirus (HPV) vaccine in Scotland has led to a "profound reduction" in cervical disease in later life, a study reveals.

In the first major analysis of the immunisation programme's impact in Scotland, scientists found that it had delivered a dramatic 89 per cent fall in incidence for the most serious pre-cancerous lesions.

The prevalence of abnormalities graded 3 or worse - the most likely to become cancerous - varied from 59 per 10,000 among unvaccinated women born in 1988, to just six per 10,000 among women born between 1995 and 1996 who had received the HPV jab.

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Similar patterns were found for incidence of the Grade 1 and Grade 2 lesions.

The results were adjusted to account for variations in deprivation and rurality, both "important predictors of cervical disease in Scotland".

The researchers found that the effectiveness of the vaccine was significantly higher among women who had been immunised aged 12 to 13 than among those who had had the jab as part of a catch-up programme aged 17.

The results, published today in the British Medical Journal, are described as "dramatic" and "document a considerable reduction in high grade cervical disease over time".

The authors said it underlined the case to roll out the vaccine as widely as possible internationally as part of the World Health Organisation's goal to eradicate cervical cancer as a public health problem.

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They write: "Routine vaccination of girls aged 12-13 years with the HPV vaccine in Scotland has led to a dramatic reduction in pre-invasive cervical disease.

"The bivalent vaccine [which protects against two HPV strains, 16 and 18] is confirmed as being highly effective vaccine and should greatly reduce the incidence of cervical cancer.

"The findings will need to be considered by cervical cancer prevention programmes worldwide."

The findings are based on the results of smear tests from 138,692 women born between 1988 and 1996 who had attended for their first cervical cancer screen aged 20 - before the starting age was raised to 25.

Since 2008, all schoolgirls aged 12 to 13 in Scotland have been invited to have the HPV jab to protect them against the virus, which is sexually transmitted.

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Cervical cancer is the most common form of the disease among women under 35 in Scotland, and the vast majority of cases of cervical cancer are linked to two particular strains of HPV which the vaccine protects against.

Dr Kevin Pollock, senior research fellow at Glasgow Caledonian University and co-author of the study, said: "The conclusion is that the vaccine has exceeded expectation.

"It is associated with near elimination of both low and high grade cervical disease in young Scottish women eight years after the vaccine programme started.

"The figures are impressive and show a reduction of up to 90% of cervical disease abnormalities - pre-cancerous cells.

"These data are consistent with the reduced circulation of high-risk HPV infection in Scotland and confirm that the HPV vaccine should significantly reduce cervical cancer in the next few years.

"Indeed, cervical cancer cases in women aged 20-24 have reduced by 69% since 2012."

The team, led by Tim Palmer at Edinburgh University's department of pathology, in collaboration with scientists from Glasgow Caledonian University, Health Protection Scotland, Aberdeen University, Strathclyde University and disease prevention experts from France.

Unvaccinated women also showed a reduction in disease, suggesting that interruption of HPV transmission in Scotland has created substantial herd protection.

The researchers point to some limitations. For example, the analysis was confined to women who attended cervical screening at age 20 - 51% for vaccinated women and 23% for unvaccinated women. This could lead to an over-estimation of vaccine effectiveness.

However, the high uptake of vaccination, similarity in distribution of HPV type in attenders and non-attenders, and the appearance of herd protection “give reassurance that the observations can be extrapolated to the general population,” they write.

Writing a comment piece on the study for the BMJ, Julia Brotherton - medical director at Australian cervical cancer research body, the VCS Foundation - said the study highlights the value of integrated health statistics registries such as Scotland's which “can systematically collect and use high-quality data from screening and vaccination programmes".

She added: "We must work towards a world in which all girls and their families are offered, and the majority accept, HPV vaccination, wherever they live.

"We must also actively develop, resource, and scale-up more effective, feasible and culturally acceptable strategies for cervical screening, such as self-collection of specimens, if we are ever to effectively reduce the global burden of cervical cancer.”