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HPV vaccine could benefit women with cervical disease

Vaccinated women have 46% reduced recurrence of HPV related diseases

Adrian O'Dowd

Wednesday, 28 March 2012

Women who are already diagnosed with pre-cancerous cervical conditions after receiving the human papillomavirus (HPV) vaccine can still benefit from a much reduced risk of the disease reoccurring, according to a study published online today by the BMJ.

The risk of HPV related disease recurring was reduced by around 46% in women who already had HPV but who still received the HPV vaccine, a team of international researchers found.

The researchers analysed data on 1,350 women from 24 countries across the world. All the women were aged between 15 and 26 between 2001 and 2003.

The women had had either HPV quadrivalent vaccine or placebo during one of two randomised controlled trials that involved more than 17,000 women and were then diagnosed with HPV-related vaginal or vulval diseases (including genital warts) or had cervical surgery.

The women in the trials were followed for approximately four years, but this new study looks only at those women who then developed HPV-related disease.

Previous studies have shown that HPV vaccination does not reduce progression to cervical pre-cancers in women with ongoing infections at the time of vaccination.

However, no studies so far have looked at the impact of HPV vaccination in preventing subsequent disease after treatment for such pre-cancers.

This new study set out to see if the vaccine decreased the risk of developing subsequent disease after the first definitive treatment.

Among women who needed cervical surgery after the trials, the risk of getting any subsequent HPV related disease was 6.6 cases per 100 women per year among the 587 women who had had HPV vaccine. For the 763 women who had had placebo the risk was 12.2 cases per 100 women per year. This meant that vaccinated women had 46.2% less risk.

In addition, vaccination was associated with a significant reduction in risk of any subsequent high grade disease of the cervix by 64.9%.

For the women who were diagnosed with vaginal or vulvar disease, the reduction in risk of any HPV disease after diagnosis and treatment among those who had had HPV vaccine was 35.2%.

In conclusion, the authors said that although vaccination did not reduce progression to disease in women who are infected with HPV at the time of vaccination, vaccinated women who developed disease after taking part in these randomised controlled trials had less frequent subsequent disease.

The authors suggested that only long-term surveillance of the vaccinated population can “determine the population effectiveness of vaccination” and added that there are several programmes currently in place to monitor the safety and impact of HPV vaccines on subsequent diseases.

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