{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T06:24:17Z","timestamp":1758781457711,"version":"3.44.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/open-government-licence\/version\/3\/"}],"funder":[{"name":"National Institute for Health and Care Research Applied Research Collaboration West"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In England, the national human papillomavirus (HPV) immunization programme was introduced in 2008 to prevent cervical cancer. Girls aged 12\u201313\u00a0years were offered routine vaccination and those aged 14\u201318\u2009years in 2008 were offered \u2018catch-up\u2019 vaccination. We evaluate the effect of the HPV catch-up vaccination programmes on cervical cancer and cervical dysplasia diagnoses, and provide an estimate of the vaccine effectiveness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using the 2011 Census, Hospital Episode Statistics, and mortality data for the population of England, we exploit the cut-off in eligibility and apply a regression discontinuity design to assess the impact of HPV vaccination on cervical disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Vaccination reduced the incidence of cervical dysplasia and cancer diagnoses by 31% and 75%, respectively, at ages 23\u201330\u2009years in girls offered catch-up vaccination at ages 17\u201318\u2009years compared with those who were just above the eligibility age for the catch-up vaccination, with a clear discontinuity. Reductions continued amongst girls offered routine vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These estimates, obtained by using a quasi-experimental approach, are similar to vaccine effectiveness estimates based on more traditional approaches. This approach provides further evidence of the HPV vaccination programme reducing adverse cervical outcomes in young women and could be used for future studies to evaluate major changes in HPV vaccination policy and for studies of longer-term outcomes including other cancers and deaths.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyaf156","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T11:51:49Z","timestamp":1755085909000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the effectiveness of the human papillomavirus vaccination programme in England, using a regression discontinuity design"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7724-567X","authenticated-orcid":false,"given":"Isobel L","family":"Ward","sequence":"first","affiliation":[{"name":"Health Research Group, Office for National Statistics , Newport,","place":["UK"]},{"name":"Population Health Sciences, Bristol Medical School, University of Bristol , Bristol,","place":["UK"]},{"name":"The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte R","family":"Bermingham","sequence":"additional","affiliation":[{"name":"Health Research Group, Office for National Statistics , Newport,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0361-3174","authenticated-orcid":false,"given":"Kate","family":"Soldan","sequence":"additional","affiliation":[{"name":"UK Health Security Agency , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0160-217X","authenticated-orcid":false,"given":"Vah\u00e9","family":"Nafilyan","sequence":"additional","affiliation":[{"name":"Health Research Group, Office for National Statistics , Newport,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"author":"Cancer Research UK","key":"2025092406331286900_dyaf156-B1"},{"year":"2015","author":"Public Health England","key":"2025092406331286900_dyaf156-B2"},{"year":"2023","author":"UK Health Security Agency","key":"2025092406331286900_dyaf156-B3"},{"key":"2025092406331286900_dyaf156-B4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1038\/sj.bjc.6605747","article-title":"Multi-site study of HPV type-specific prevalence in women with cervical cancer, intraepithelial neoplasia and normal cytology, in England","volume":"103","author":"Howell-Jones","year":"2010","journal-title":"Br. 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Cancer"},{"key":"2025092406331286900_dyaf156-B5","doi-asserted-by":"crossref","first-page":"F123","DOI":"10.1016\/j.vaccine.2012.04.108","article-title":"A review of clinical trials of human papillomavirus prophylactic vaccines","volume":"30 Suppl 5","author":"Schiller","year":"2012","journal-title":"Vaccine"},{"key":"2025092406331286900_dyaf156-B6","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1038\/nrclinonc.2013.84","article-title":"Clinical trials of human papillomavirus vaccines and beyond","volume":"10","author":"Lehtinen","year":"2013","journal-title":"Nat Rev Clin Oncol"},{"key":"2025092406331286900_dyaf156-B7","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1016\/S0140-6736(21)02178-4","article-title":"The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study","volume":"398","author":"Falcaro","year":"2021","journal-title":"Lancet"},{"key":"2025092406331286900_dyaf156-B8","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1093\/jnci\/djad263","article-title":"Invasive cervical cancer incidence following bivalent human papillomavirus vaccination: a population-based observational study of age at immunization, dose, and deprivation","volume":"116","author":"Palmer","year":"2024","journal-title":"JNCI J Natl Cancer Inst"},{"key":"2025092406331286900_dyaf156-B9","doi-asserted-by":"crossref","first-page":"100946","DOI":"10.1016\/j.ehb.2020.100946","article-title":"Human papillomavirus vaccine and risky sexual behavior: regression discontinuity design evidence from Brazil","volume":"40","author":"Frio","year":"2021","journal-title":"Econ Hum Biol"},{"key":"2025092406331286900_dyaf156-B10","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1093\/aje\/kwz043","article-title":"Evaluating the effectiveness of vaccines using a regression discontinuity design","volume":"188","author":"Basta","year":"2019","journal-title":"Am J Epidemiol"},{"key":"2025092406331286900_dyaf156-B11","doi-asserted-by":"crossref","first-page":"e1131","DOI":"10.1542\/peds.2014-2961","article-title":"The early benefits of human papillomavirus vaccination on cervical dysplasia and anogenital warts","volume":"135","author":"Smith","year":"2015","journal-title":"Pediatrics"},{"key":"2025092406331286900_dyaf156-B12","first-page":"939","article-title":"Strategies for evaluating the assumptions of the regression discontinuity design: a case study using a human papillomavirus vaccination programme","volume":"46","author":"Smith","year":"2017","journal-title":"Int J Epidemiol"},{"key":"2025092406331286900_dyaf156-B13","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1097\/EDE.0000000000000138","article-title":"Regression discontinuity designs in epidemiology: causal inference without randomized trials","volume":"25","author":"Bor","year":"2014","journal-title":"Epidemiology"},{"key":"2025092406331286900_dyaf156-B14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.37737\/ace.22001","article-title":"Introduction to regression discontinuity design","volume":"4","author":"Sasabuchi","year":"2022","journal-title":"Ann Clin Epidemiol"},{"key":"2025092406331286900_dyaf156-B15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ije\/dyad194","article-title":"Cohort profile: the public health data asset, 2011 cohort","volume":"53","author":"Nafilyan","year":"2024","journal-title":"Int J Epidemiol"},{"year":"2012","author":"Department of Health","key":"2025092406331286900_dyaf156-B16"},{"key":"2025092406331286900_dyaf156-B17","doi-asserted-by":"crossref","first-page":"e0150107","DOI":"10.1371\/journal.pone.0150107","article-title":"HPV serology testing confirms high HPV immunisation coverage in England","volume":"11","author":"Mesher","year":"2016","journal-title":"PLoS One"},{"author":"Calonico","key":"2025092406331286900_dyaf156-B18"},{"year":"2019","author":"Ministry of Housing Communities and Local Government","key":"2025092406331286900_dyaf156-B19"},{"key":"2025092406331286900_dyaf156-B20","doi-asserted-by":"crossref","first-page":"2239085","DOI":"10.1080\/21645515.2023.2239085","article-title":"Human papillomavirus vaccine effectiveness by age at vaccination: a systematic review","volume":"19","author":"Ellingson","year":"2023","journal-title":"Hum. 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