The U.S. could eliminate cervical cancer. What's the holdup?

An extraordinary cancer statistic recently dropped in a major medical journal: zero.

That’s the number of women in their early 20s in England who died from HPV-related cervical cancer between 2020 and 2024. They’re the beneficiaries of widespread HPV vaccination, according to a new study published in The Lancet.

That stunning result was published the same month that the U.S. marked 20 years since the first HPV vaccine became available. It’s a public health tool that continues to go frustratingly underused in some parts of the country.

Over the past two decades, the profound benefits of protecting women against the most dangerous types of HPV have manifested exactly as researchers had hoped. The first good sign was a drop in HPV infections among the earliest groups of girls to receive the vaccine. Then came evidence that women who were vaccinated in their teens had dramatically fewer cases of cervical cancer. Now, of course, comes the amazing news that the vaccine is saving lives.

The vaccine has proved itself in other important ways, too. For example, when the shots first landed, people worried their protection might not last. But studies have since shown that protection "basically never wears off,” says Rebecca Perkins, a Tufts University School of Medicine professor who researches cervical cancer prevention and HPV vaccination. And while adolescents originally needed three shots, studies have since found that two work just as well — and there’s growing evidence one might be enough.

"Over the years, all of the news has been good,” says Perkins.

The hope now is that this wave of good news will one day be replicated with other HPV-related cancers, like the head and neck tumors that have been on the rise in recent years and disproportionately affect men.

The UK study lays out the promise of a future where people are no longer dying from preventable diseases. It’s a future the U.S. should be aggressively working toward.

"We’ve made incredible progress, but we still have a lot of work to do in the United States to get to that milestone of elimination,” says Heather Brandt, director of the HPV Cancer Prevention Program at St. Jude Children’s Research Hospital.

Achieving elimination status will require an ongoing effort to get more adolescents vaccinated. Uptake of the vaccine among tweens and teens varies greatly depending on where someone lives — and there are still too many pockets of the country where less than half eligible kids are protected.

In an ideal world, U.S. health officials would tackle those disparities by laying out a comprehensive strategy for eliminating cervical and other HPV-related cancers. Given Health Secretary Robert F. Kennedy Jr.’s anti-vaccine leanings — and his past involvement in lawsuits against HPV vaccine manufacturers — such an effort seems unlikely during this administration.

Still, there’s a lot that could still be done to get the country closer to that goal. Already, medical groups, patient advocates and hospital systems have teamed up to increase the public health impact of HPV vaccination, and they could formalize an elimination strategy and timeline. More states could take a page from places like Alabama, which in 2023 became the first to launch its own effort to eliminate cervical cancer entirely.

A few small, practical changes by healthcare providers could help move the needle. Doctors have the biggest influence over parents’ decisions to vaccinate their kids. "When a provider recommends an HPV vaccine, children are far more likely to receive it,” says Noel Brewer, a professor at the University of North Carolina’s school of public health.

Brewer helped create an evidence-backed method that more physicians should be using when talking to parents about HPV vaccines. The "announcement approach” calls for physicians to set vaccination as the norm by simply stating that a child is due for a shot. If a parent has questions or expresses hesitancy, the next step is to ask about their main concern — and then actively listen to their reply. "This is very important,” Brewer says. "When the provider repeats what they’ve heard, it helps the parent to know that they’ve been understood.”

If a parent still declines, the physician then notes they will revisit the conversation at a child’s next visit.

Which brings me to another simple way to improve uptake: Physicians everywhere should start recommending the vaccine at age 9. Although the HPV vaccine has for years been available to kids at age 9, the Centers for Disease Control and Prevention’s vaccine advisers, a group doctors often defer to for guidance, recommend its use at age 11. That might sound like a small difference, but it has big real-world implications. For example, the shot typically doesn’t show up in state immunization systems or a child’s electronic health record as due until 11.

Offering it at age 9, an approach the American Academy of Pediatrics endorsed several years ago, has a few built-in advantages. The shot would be recommended during a year when kids aren’t getting other vaccines, and well before a child is sexually active, potentially removing any stigma parents might associate with it. (HPV is transmitted by sexual contact.)

It also gives providers more opportunities to try again if a parent refuses the shot — and improves the chances of success during the age range when kids produce the most antibodies after vaccination. That’s key, since studies have found most parents do change their minds when a provider raises the issue again.

For 20 years now, the U.S. has had a tool that can prevent cancer, spare people unnecessary anxiety and pain, and save lives. It’s past time to maximize its potential.

This column reflects the personal views of the author and does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners. Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.