Increased incidence of cervical cancer in Sweden: an unlikely link with human papillomavirus (HPV) vaccination

In 2017, the Centre for Cervical Cancer Prevention in Sweden (NKCx) reported an increase in the Swedish cervical cancer incidence from 9.7/100 000 in 2006–2009 to 11.5/100 000 in 2014–2015 with a p value of 0.03 (see the Swedish report’s Table 9 on PDF page 49 of 87).1 In April 2018, the Indian Journal of Medical Ethics (IJME) published a comment entitled 'Increased incidence of cervical cancer in Sweden: possible link with HPV vaccination'. In May 2018, the comment was retracted, because its author had used a pseudonym, which violated IJME’s policy.2 Sweden’s human papillomavirus (HPV) vaccination programme was introduced in 2010, and the IJME comment author hypothesised that the increase in cervical cancer was possibly linked with HPV vaccination. Here, we argue why this is unlikely. In 2010, Sweden initiated its HPV vaccination programme for girls aged 12 to 15 years. The Swedish report included data up until the end of 2015 for women aged 20 years and older.1 Thus, very few of those who were included in the HPV vaccination programme were included in the Swedish report. In 2010, Sweden also conducted a catch-up vaccination programme for girls aged 15 to 18 years, who were 20 to 23 years old in 2015 and therefore included in the Swedish report.1 However, nearly half (41%) of this catch-up cohort was …