Projections of human papillomavirus (HPV) vaccination impact on non-cervical cancer outcomes among women in 117 low- and middle-income countries: a modelling study

Abstract

Introduction Human papillomavirus (HPV) is a leading cause of both cervical and non-cervical cancers, including anal, oropharyngeal, vaginal and vulvar cancers. While most HPV vaccination impact assessments have focused on preventing cervical cancer among women, the broader benefits of vaccination against other HPV-attributable cancers in low- and middle-income countries (LMICs) remain less explored. Methods We used a static cohort model to assess the potential health impact of bivalent HPV vaccination on HPV-attributable female non-cervical cancers in 117 LMICs from 2030 to 2100. The model incorporated country-specific data on cancer mortality, HPV type distribution, demographic projections and vaccine coverage. Sensitivity analyses were performed to account for uncertainties in cancer incidence, cancer mortality and HPV type distribution. Results Our projections suggest that HPV vaccination could contribute to prevention of approximately five 90 000 cases of anal, 880 000 cases of oropharyngeal, 1.27 million cases of vaginal and 2.18 million cases of vulvar cancers over the analytic period. In total, 3.02 million deaths from these non-cervical cancers among women could be averted by 2100. The African region is expected to see the largest relative reductions in both cases and deaths while the European region showed the smallest gains. By the end of the century, 58 countries are projected to reach at least a 25% reduction in anal cancer mortality compared with just 25 countries for oropharyngeal cancer. These findings reflect substantial regional disparities in both burden and vaccination impact. Conclusion HPV vaccination holds considerable promise in reducing the burden of non-cervical cancers among women in LMICs, especially in regions with high incidence and limited access to care. Recognising and harnessing these broader benefits can strengthen the public health case for scaling up vaccine access, implementing region-specific strategies and investing in equitable healthcare systems to decrease global disparities.