Strategic implementation of HPV vaccination to eliminate cervical cancer in Georgia

Human Papillomavirus (HPV) is a prevalent sexually transmitted infection and a leading cause of cervical cancer. In Georgia, cervical cancer ranks as the fifth most common cancer among women, with approximately 330 new cases and 200 deaths reported annually. Despite the availability of effective HPV vaccines, national vaccination coverage remains low. This study aimed to evaluate HPV vaccination coverage, analyze cervical cancer incidence trends, and model the potential impact of increased vaccination uptake on cancer prevention outcomes in Georgia.

A retrospective observational study was conducted using national health registry data and modeling projections to assess the burden of cervical cancer and estimate the effect of scaled vaccination coverage.

National health databases were used to analyze HPV vaccination rates and cervical cancer incidence. Descriptive statistics, chi-square tests, and linear regression were applied to identify trends and disparities. Additionally, a dynamic transmission model was developed to simulate the 10-year impact of increasing HPV vaccination coverage on cervical cancer incidence.

The crude cervical cancer incidence rate was 15.7 per 100,000 women, with an age-standardized rate of 10.6 per 100,000. In 2022, only 38 % of eligible girls aged 13-18 received the first HPV vaccine dose, and 26 % completed the second dose. Regional disparities in vaccination and screening were noted, and overall screening coverage declined to 13,890 women screened in 2022. Modeling showed that increasing vaccine coverage to 60 % could reduce cervical cancer incidence by 50 % (preventing ∼163 cases); coverage of 80 % and 90 % could reduce incidence by 70 % and 85 %, preventing 228 and 276 cases, respectively.

Low HPV vaccination uptake in Georgia (38 % first dose and 26 % dull coverage) and declining screening limit cervical cancer prevention. Modeling shows that increasing vaccination coverage to 60-90 % could prevent 163-276 cases over the next decade. Strengthening vaccination and screening strategies is essential to move forward elimination.