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Increased incidence of cervical cancer in Sweden: an unlikely link with human papillomavirus (HPV) vaccination
  1. Lars Jørgensen1,2,
  2. Peter Christian Gøtzsche1,
  3. Tom Jefferson2
  1. 1 Institute for Scientific Freedom, Copenhagen, Denmark
  2. 2 Nordic Cochrane Centre, Copenhagen, Denmark
  1. Correspondence to Dr Lars Jørgensen, Copenhagen, Hovedstaden, Denmark; lj{at}cochrane.dk

https://doi.org/10.1136/bmjsrh-2018-200245

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    Background

    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 In May 2018, the comment was retracted, because its author had used a pseudonym, which violated IJME’s policy.2 Sweden’s human papillomavirus (HPV) vaccination programme was introduced in 2010, and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.

    The Swedish report included only a minority of the Swedish HPV vaccinees

    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 not HPV vaccinated, and …

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    Footnotes

    • Twitter @@LarsJorgensenMD

    • Correction notice Since this paper was first published online, Peter Gøtzsche's affiliation has been updated to the Institute for Scientific Freedom.

    • Contributors LJ wrote the first draft. LJ, PCG and TJ contributed to the conception, drafting, critical revision for important intellectual content and the final approval of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PCG spoke by video link about the HPV vaccines at the IFICA conference in 2018 but received no fee or reimbursement for this. PCG and TJ were co-signatories of a complaint to the European Ombudsman on maladministration in relation to the EMA investigation of possible harms from HPV vaccines. PCG does not regard this as a competing interest. TJ was a co-recipient of a UK National Institute for Health Research grant (HTA – 10/80/01 Update and amalgamation of two Cochrane Reviews: neuraminidase inhibitors for preventing and treating influenza in healthy adults and children –https://www.journalslibrary.nihr.ac.uk/programmes/hta/108001%23/). TJ is also in receipt of a Cochrane Methods Innovations Fund grant to develop guidance on the use of regulatory data in Cochrane reviews. TJ is occasionally interviewed by market research companies about phase I or II pharmaceutical products. In 2011–2014, TJ acted as an expert witness in a litigation case related to the antiviral oseltamivir, in two litigation cases on potential vaccine-related damage, and in a labour case on influenza vaccines in healthcare workers in Canada. He has acted as a consultant for Roche (1997–1999), GSK (2001–2002), Sanofi-Synthelabo (2003) and IMS Health (2013). In 2014–2016, TJ was a member of three advisory boards for Boehringer Ingelheim. TJ was a member of an independent data monitoring committee for a Sanofi Pasteur clinical trial on an influenza vaccine. A full disclosure is here https://restoringtrials.org/competing-interests-tom-jefferson/

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.