HPV vaccine has reduced cervical pre-cancers in young women

By John Murphy, MDLinx
Published September 30, 2016

Key Takeaways

Rates of precancerous cervical lesions in women under age 25 have dropped significantly in New Mexico since 2007, when the human papilloma virus (HPV) vaccine was introduced, according to a study published September 29, 2016 in JAMA Oncology.

These results, which were greater than experts anticipated, demonstrate that the HPV vaccine has effectively reduced cervical pre-cancers among young women throughout the state. The results also suggest that raising the age for cervical cancer screening may soon be appropriate, the researchers noted.

For this study, researchers used data from the New Mexico HPV Pap Registry (NMHPVPR), which is the only statewide surveillance program in the United States that includes complete cervical screening, diagnosis, and treatment information since the introduction of the HPV vaccine in 2007.

In 2008, 48% of girls 13 to 17 years old in New Mexico had received at least one dose of HPV vaccine, and 17% received all three doses. By 2014, that percentage increased to 59% of girls who received at least one dose of HPV vaccine, while 40% received all three doses.

The researchers found that among women who were 15 to 19 years old at the time of a diagnostic cervical biopsy, the incidence rate of all cervical intraepithelial neoplasias (CIN)—grades 1 to 3—decreased between 2007 and 2014. Among women 20 to 24 years old during the same period, the incidence rate of moderate-grade pre-cancerous lesions (CIN grade 2) also declined.

These rate reductions were greater than expected based on HPV vaccination coverage in the state. The researchers speculated that several factors likely contributed to lower incidence, including cross-protection against HPV types not targeted by the vaccine, efficacy of fewer than 3 vaccine doses, and herd immunity.

But higher rates of all grades of CIN did occur in the oldest age group (25 to 29 years old), with a notable increase observed in later years. “This finding has been seen in other investigations and is believed to reflect longer intervals between screens and more HPV testing associated with increases in colposcopy referral and CIN detection within this age group,” the authors wrote.

Overall, “the data suggests that the age at which we begin cervical screening in the United States might be raised soon to age 25, as is already done in a number of other countries,” said study leader Cosette Wheeler, PhD, Regents Professor in the Departments of Pathology and Obstetrics and Gynecology at the University of New Mexico Health Sciences Center, in Albuquerque, NM.

“Raising the age at which we begin cervical screening would be one of the first steps in integrating cervical screening and HPV vaccination, an important step in using healthcare dollars more effectively,” Dr. Wheeler added. “When cervical cancer screening guidelines are revisited soon, these results from New Mexico may be considered in the review process.”

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