The researchers say their study results strongly indicate population immunity.
Increases in HPV vaccination rates were lower than expected.
Of the 19.9 million children who either have no vaccines or only partial DTP vaccination coverage, 55% live in 10 countries.
Much less improvement was seen among participants who were Black or lived in rural or disadvantaged areas.
Results point to a need to increase HPV vaccine uptake and screening, the authors say.
Worldwide HPV vaccination coverage is only 27% for girls and women with the first dose and 20% for full doses, study finds.
Positive provider attitude and self-efficacy toward screening, larger institution size, recent training, and college policy were tied to higher screening rates.
Relative to HPV-negative participants, those with HPV had a 40% higher risk of cardiovascular disease and twice the risk of coronary artery disease.
Precancer incidence has decreased 80% among screened women aged 20 to 24 years.
Researchers said the findings are concerning, especially because the rates of HPV-linked throat and tongue cancers in men are rising.
