HPV vaccination and cervical cancer control in Georgia: evidence and projections.
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INTRODUCTION: Human Papillomavirus (HPV) is the primary cause of cervical cancer. In Georgia, cervical cancer is the fifth leading cause of cancer-related deaths among women, with approximately 330 new cases and 200 deaths annually. Although HPV vaccines are included in the national immunization programme, coverage remains suboptimal. This study aimed to assess national trends in HPV vaccination, cervical cancer screening, and incidence in Georgia, and to project the potential impact of improved vaccination coverage. MATERIALS AND METHODS: National data from 2016–2022 were analysed using descriptive statistics, chi-square tests, and linear regression. Cumulative risk and age-standardized rates were calculated using WHO-recommended methods. Scenario-based simulation models projected reductions in cervical cancer incidence assuming vaccination coverage of 60%, 80%, and 90% through 2032. RESULTS: In 2022, only 38% of eligible adolescents received the first HPV vaccine dose and 26% completed the second. Regional variation was substantial (83% in Adjara vs. 14% in Shida-Kartli), with consistently lower uptake in rural than urban areas. Screening participation declined from 26,348 women in 2016 (4.4% of eligible) to 13,890 in 2022 (2.3%). Regression analysis showed an inverse but non-significant association between vaccination coverage and cervical cancer incidence (β = − 0.12, 95% CI − 0.32 to 0.08, p = 0.18). Simulation models projected that 90% coverage could prevent up to 276 cases over the next decade. CONCLUSION: HPV vaccination coverage in Georgia remains insufficient, with regional disparities and declining screening participation. Scaling up vaccination to ≥ 80% and integrating it with screening could substantially reduce cervical cancer burden and accelerate progress toward WHO elimination targets.