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HPV vaccination alongside medical procedures for cervical lesions may reduce threat of further disease

HPV vaccine
Gardasil vaccine and box. Image: Wikipedia

Giving women the human papillomavirus (HPV) vaccine round the time they will have surgery for precancerous cervical lesions might trigger a decrease in the chance of lesions returning along with other HPV-related diseases, suggests a report published by The BMJ today.

The researchers stress, however, that the grade of evidence ranged from suprisingly low to moderate and additional top quality trials are essential to verify these results.

HPV vaccination is impressive at avoiding the development of precancerous (cervical intraepithelial neoplasia or CIN).

Many countries, like the UK, offer HPV vaccination to kids round the age of 12 or 13 to safeguard them against cervical cancer, along with other related cancers, in later life.

CIN is split into three grades: CIN1, two or three 3.

Women who’ve been treated for high quality CIN have a lifelong residual risky of cervical along with other malignancies linked to HPV infection, plus some research shows that giving a preventive HPV alongside treatment for CIN will help to reduce the chance in these women.

To explore this further, researchers analyzed the outcomes of 18 studies to measure the aftereffect of HPV vaccination on threat of HPV infection or recurrence of lesions linked to HPV infection after local medical procedures.

These included two randomized controlled trials (RCTs), 12 observational studies, and four post hoc analyses of RCTs (when researchers re-examine data following a trial has finished).

Both trials were classified as low threat of bias, within the observational studies and post hoc analyses, threat of bias was moderate for seven, serious for seven, and crucial for two. Average amount of follow-up was 36 months.

The outcomes show that the chance of recurrence of high quality preinvasive disease (CIN2+) was reduced by 57% in individuals who have been vaccinated weighed against those who weren’t vaccinated.

The result estimate was even stronger (a member of family 74% reduction) once the threat of recurrence of CIN2+ was assessed for disease linked to both high-risk HPV types (HPV16 and HPV18), which will be the reason behind most cervical cancers.

However, the researchers remember that these effects are unclear due to the scarcity of data and the moderate to high overall threat of bias of the available studies.

The chance of recurrence of higher grade CIN3 was also low in patients who have been vaccinated but again, there is a high degree of uncertainty concerning the quality of the evidence.

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

The researchers acknowledge several limitations. For instance, the majority of the studies were observational, of low to moderate quality, sufficient reason for relatively short follow-up times, preventing assessment of longterm effects.

Also, average age of participants had not been provided generally in most studies, and factors such as for example smoking (of a higher threat of recurrence) weren’t controlled for in lots of studies.

However, they state their usage of stringent study inclusion criteria as well as rigorous and systematic evaluation of study quality and threat of bias suggests the outcomes are robust.

Therefore, they conclude that HPV vaccination might decrease the threat of recurrence of CIN, specifically when linked to HPV16 or HPV18, in women treated with local excision, even though quality of evidence indicated that the info were inconclusive.

Large scale, top quality randomized controlled trials must establish the amount of effectiveness and cost of HPV vaccination in women, they add.



More info: Role of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local medical procedures: systematic review and meta-analysis, The BMJ (2022). DOI: 10.1136/bmj-2022-070135

Citation: HPV vaccination alongside medical procedures for cervical lesions may reduce threat of further disease (2022, August 3) retrieved 3 August 2022 from https://medicalxpress.com/news/2022-08-hpv-vaccination-surgical-treatment-cervical.html

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