HPV Vaccination Reduced Cervical Precancer Recurrences

Adjuvant HPV vaccination with surgical excision prevented recurrent CIN2+ cases
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(Vax Before Cancer)

A recent study performed a systematic review and meta-analysis evaluating the efficacy of adjuvant human papillomavirus (HPV) vaccination in preventing recurrent CIN2+ after surgical excision.

On March 29, 2020, this study’s findings were posted online and reported ‘adjuvant HPV vaccination after surgical excision for CIN2+ significantly reduces the risk of both recurrent high-grade and low-grade cervical dysplasia.’

Furthermore, ‘the risk of recurrent lesions caused by the most oncogenic strains, HPV 16/18, is also significantly reduced with adjuvant HPV vaccination.’ 

‘HPV vaccination should, therefore, be considered for adjuvant treatment to surgery in patients undergoing surgical excision for CIN2+.’

This review considered 6 previous studies that met the inclusion criteria. Of the 2,984 women included in the studies, 1,360 (45.6%) received adjuvant HPV vaccination after surgical excision, and 1,624 (54.4%) received either placebo or surgical management alone for CIN2+.

Recurrence of CIN2+ occurred within 6–48 months in 99 women (3.3%) overall; however, it was significantly lower for vaccinated women, 23 of 1,360 women (1.7%) versus 76 of 1,624 unvaccinated women (4.7%) (RR = 0.34, 95% CI 0.22–0.55). 

Similarly, the risk of CIN1+ was also significantly lower with adjuvant HPV vaccination, occurring in 86 of 1,360 vaccinated women (6.3%) versus 157 of 1,624 unvaccinated women (9.7%) (RR = 0.67, 95% CI 0.52–0.85). 

Four studies evaluated the recurrence of lesions specific to HPV strains 16/18. 

There were 35 women who developed recurrent HPV 16/18 CIN2+, 9 women who received adjuvant vaccination (0.9%), and 26 women who did not receive the vaccine (2.0%). 

In addition, 49 women developed HPV 16/18 associated CIN1+: 11 vaccinated women (1.1%) and 38 unvaccinated women (3.1%). 

Overall, there was a statistically significant reduction in the risk of HPV 16/18 associated CIN2+ lesions (RR = 0.41, 95% CI 0.20–0.85) and HPV 16/18 associated CIN1+ lesions (RR = 0.35, 95% CI 0.18-0.67).

HPV is the most common sexually transmitted infection in the USA, and persistent infection with certain types of the virus can cause cervical cancer.

About 14 million people, including teens, become infected with HPV each year.

To prevent infection, the Centers for Disease Control and Prevention (CDC) currently recommends both boys and girls under the age of 15 years receive a 2-dose schedule of the HPV vaccine, Gardasil 9.

The Gardasil 9 vaccine helps protect females ages 9 to 45 against cervical, vaginal, vulvar, and anal cancers and genital warts caused by 9 types of HPV. 

The vaccine has not been causally associated with adverse pregnancy outcomes or with adverse effects on the developing fetus, but data on vaccination during pregnancy are limited, says the CDC.

Cancer vaccine research published by Vax-Before-Cancer.