Dutch research confirms: young women with cervical cancer often not HPV-vaccinated
The findings of the study, based on data from the Netherlands Cancer Registry of IKNL, were presented on International HPV Awareness Day, the 4th of March 2025. The research was initiated by gynecologists from Amsterdam UMC, who are concerned about the large number of people choosing not to get the HPV vaccine.
All the women studied were eligible for the then-new HPV vaccine during their teenage years. ‘In recent years, we’ve seen several young women with cervical cancer who had not been vaccinated’, explains gynecologic oncologist Luc van Lonkhuijzen of Amsterdam UMC. ‘It’s difficult to accept that their illness might have been preventable. With this study, we want to raise awareness about the importance of HPV vaccination. It can prevent a lot of suffering.’
First Dutch Study
The protective effect of vaccination against (pre-stages of) cervical cancer had already been shown in several large international studies. This is the first study to demonstrate the effect of the HPV vaccine among young women in the Netherlands. Researchers also looked at the impact of the treatments these women underwent. Of the 135 women studied, 58% underwent cancer treatment that resulted in loss of fertility.
Van Lonkhuijzen: ‘That’s obviously very drastic, even aside from the risk of death from cervical cancer. If we can prevent cervical cancer through vaccination, then these treatments - and therefore infertility - wouldn’t be necessary.’
HPV and Cancer
Cervical cancer is usually caused by an HPV infection, a virus that nearly everyone contracts at some point in life. In most cases, the body clears the virus on its own. But when it doesn’t, HPV can eventually lead to cervical cancer (as well as vaginal and vulvar cancer in women, penile cancer in men, and anal and oropharyngeal cancer in both sexes).
The HPV vaccine was added to the Dutch National Immunization Programme in 2010, initially for girls only and, since 2022, also for boys. Currently, the vaccine is offered to children in the year they turn 10. Until 2022, girls were offered the vaccine at age 13. Catch-up campaigns were conducted in 2009, 2022, and 2023 for older girls, and starting in 2022 for boys as well.
Unfortunately, many people still choose not to get the vaccine. In the early years, only about 50-60% of girls were vaccinated. Thanks to catch-up campaigns, the current vaccination rate among girls born between 1997 and 2010 has risen to at least 60-70% (source: RIVM).
‘We must do everything we can to raise that percentage’, says lead researcher Maaike van der Aa from IKNL, who was involved in the study. ‘Recent campaigns gave young people another chance to get vaccinated, but a large proportion remains unvaccinated. Our study shows that the majority of cervical cancer cases occur in the unvaccinated group.'
We must do everything we can to raise the vaccination rate among young people
Reevaluating the Vaccine
Although HPV vaccination significantly reduces the risk of cervical cancer, the study also shows that vaccinated women can still develop the disease. According to Van der Aa, this calls for more research: ‘In the Netherlands, we use a so-called ‘bivalent’ vaccine, which protects only against HPV types 16 and 18 and not against all high-risk HPV types. More research is needed among vaccinated women who developed cervical cancer to find out what’s going on. Did they get cancer from a different high-risk HPV type? Or are there cases where cancer developed despite vaccination against HPV 16 and 18?’
Screening Remains Important
Because HPV vaccination lowers the risk of cancer but does not eliminate it, it remains important for all women to participate in cervical cancer screening, even if vaccinated. If an HPV infection is detected, a cervical smear test is required. Van Lonkhuijzen notes: ‘Cervical cancer screening is now much easier with the HPV self-test. Unfortunately, participation in this screening is also under pressure. Only about 50% of women over 30 take part’ (source: RIVM, 2023). He adds that early detection through screening (often of precancerous stages) can lead to less invasive treatment. ‘Aside from a better prognosis, this can mean a lot to women of reproductive age, as it may allow them to still have children in the future.’
About the Study
Researchers from IKNL and Amsterdam UMC conducted the study using data from the Netherlands Cancer Registry (NKR). They examined the medical records of 135 women born between 1993 and 2010 who were diagnosed with cervical cancer before the age of 30. Vaccination status was known for 84 women. The key findings:
• 85% (71/84) of women with known vaccination status had not been vaccinated.
• 58% of all 135 women with cervical cancer underwent treatment that resulted in loss of fertility.
The article based on the study has been pre-published.
* At least 55% of girls born between 1993 and 2010 were fully vaccinated against HPV by age 14. Unvaccinated individuals from this group could still participate in various catch-up rounds, resulting in a much higher current vaccination rate for this age group (source: RIVM).
Want to know more?
For media inquiries, contact Marjon Kranenbarg, spokesperson.
For more information about the study, contact IKNL lead researcher Maaike van der Aa.