HPV vaccination at time of surgery may reduce risk of cervical cancer returning

Receiving the human papillomavirus (HPV) vaccine around the time of surgery for the removal of precancerous cervical lesions (CIN) may reduce the risk of lesions returning and the chances developing other HPV-related diseases.

The HPV vaccine has been shown to dramatically reduce cervical cancer rates by almost 90% in women in their 20s who were offered the jab at age 12 to 13.¹

Now, a study published in the British Journal of Medicine (BMJ) has shown that administering a dose around the time of surgery may reduce the chance of the precancerous cells returning.

Vaccinated patients had a 57% lower risk of recurrence of high grade preinvasive disease

The researchers analysed the results of 18 studies, including two randomised controlled trials (RCTs), 12 observational studies, and four post hoc analyses of RCTs.

The results show that participants who had been vaccinated against HPV had a 57% lower risk of recurrence of high grade preinvasive disease (CIN2+) compared to those who had not been vaccinated.

The effect estimate was even stronger (a relative 74% reduction) when the risk of recurrence of CIN2+ was assessed for disease related to the two high-risk HPV types (HPV16 and HPV18), which are the cause of most cervical cancers.

However, when the studies were quality checked, they were found to range from very low to moderate. The researchers therefore warn that further high-quality trials are needed to confirm the results.

The risk of recurrence of higher grade CIN3 was also reduced in patients who were vaccinated but again, there was a high level of uncertainty about the quality of this evidence.

Evidence was also lacking on the benefit of HPV vaccination for recurrence of vulvar, vaginal or anal lesions, and genital warts.

Further high-quality trials needed to confirm results

As well as the varying quality of the studies, the researchers say that average age of participants was not provided in most studies, and factors such as smoking (associated with a higher risk of recurrence) were not controlled for in many studies.

However, they say their use of stringent study inclusion criteria together with rigorous and systematic evaluation of study quality and risk of bias suggests the results are robust.

As such, they conclude that HPV vaccination might reduce the risk of recurrence of CIN, in particular when related to HPV16 or HPV18, in women treated with local excision, although the quality of evidence indicated that the data were inconclusive.

References

1. Cancer Research UK (2021) €œThe power of science€: HPV vaccine proven to dramatically reduce cervical cancer, accessed August 2022, available at: https://news.cancerresearchuk.org/2021/11/03/the-power-of-science-hpv-vaccine-proven-to-dramatically-reduce-cervical-cancer/