HPV vaccination linked to ‘dramatic’ fall in cervical disease

Henrietta Brewer
April 6, 2019

The HPV vaccine has led to "profound reduction" in the rate of precancerous cervical changes in Scotland.

The human papillomavirus (HPV) is a sexually-transmitted infection and some types are linked to cervical cancer, one of the most common cancers in women under 35 in the UK.

In the United States of America, the Centers for Disease Control and Prevention (CDC) recommends that adolescent boys and girls up to 15 years of age receive two doses of the HPV vaccine, beginning at age 11 or 12.

So a team led by Tim Palmer at the University of Edinburgh made a decision to use this data to measure the impact of routine vaccination of girls with the bivalent HPV vaccine (which targets HPV types 16 and 18) on levels of abnormal cells and cervical lesions (known as cervical intraepithelial neoplasia or CIN).

The higher the CIN grade, the higher the risk is of developing invasive cancer.

Compared with unvaccinated women born in 1988, vaccinated women born in 1995 and 1996 showed reductions of between 79 and 89 per cent for all grades of CIN.

This is consistent with the fact that we have also seen a big fall in high-risk HPV infection in Scotland in recent years.

The researchers note that continued monitoring of these rare types of cervical cancer is necessary when the screening of cervical cancer now is to be done by HPV testing instead of primary cytological analysis of cell samples.

Moreover, this study showed evidence of herd protection against high-grade cervical disease was found in unvaccinated girls in the 1995 and 1996 cohorts.

Research finds that young minority gay, bisexual, and other men who have sex with men have high rates of HPV infection, despite the availability of a vaccine that can prevent infection.

The authors said that the reduction in disease in routinely immunised women, who will form the bulk of the screened population in years to come, mandates revision of screening and referral guidelines.

CIN is divided into grades; CIN1, 2+ or 3+.

The success of the vaccine program is already proving to be remarkable.

According to cancer research United Kingdom, virtually all cases of cervical cancer are rooted in an HPV infection, and 3,100 cases are diagnosed each year. "Before that stage, the frequency and number of screening tests will need to be reviewed; there are suggestions that just two or three tests in a screening "lifetime" will be adequate".

Rare types of cervical cancer can be effectively prevented with screening, a comprehensive study of identified cases of rare cervical cancer over a ten-year period in Sweden concludes.

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