Human papillomavirus types in cervical dysplasia among young HPV‐vaccinated women: Population‐based nested case–control study

Kann, Hanna; Hortlund, Maria; Eklund, Carina; Dillner, Joakim; Faust, Helena

doi:10.1002/ijc.32848

Cited by 19 publications

(18 citation statements)

References 27 publications

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“…A reduced prevalence of HPV16/18 is confirmed by an earlier study, indicating that most of the cervical intraepithelial neoplasia among vaccinated cohorts were associated with non-vaccine HPV types. 28 Therefore, HPV16/18 positivity in vaccinated birth cohorts entering the screening programme will most likely be an indication of persistent infections, for example, if vaccination was initiated after prior exposure to HPV. This suggests that either decreased intensity and/or switch to primary HPV screening with partial HPV genotyping should be contemplated.…”

Section: Ppv Of Cytology For Cin2+mentioning

confidence: 99%

Impact of HPV vaccination on cervical screening performance: a population-based cohort study

et al. 2020

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BACKGROUND: Human papillomavirus (HPV) vaccination is predicted to lower the positive predictive value (PPV) of cytology. METHODS: We included 153,250 girls born between 1989 and 1993, resident in Sweden since the introduction of HPV vaccines (October 2006) and attending cervical screening at age 23 years. We assessed their first cytology and following histopathological diagnosis using Swedish National Cervical Screening Registry (NKCx). By linkage with the national Swedish HPV vaccination registry, we determined PPV of abnormal cytology for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and the differences with 95% confidence intervals (CIs) according to vaccination status. RESULTS: The PPV of high-grade cytology for CIN2+ was 69.9% (95% CI, 67.9-71.9), 64.9% (95% CI, 59.8-69.8) and 57.4% (95% CI, 50.9-63.7) among women unvaccinated, initiating vaccination at age 17-22 years and initiating vaccination before age 17 years, corresponding to reduction in PPV by 8% (95% CI, 0-15%) and 17% (95% CI, 7-26%) in vaccinated groups after adjustment for birth cohort, respectively. CONCLUSION: The PPV of cytology for CIN2+ decreased among vaccinated women, and the decrease was stronger for girls vaccinated at younger ages. A switch from cytology to HPV testing might potentially improve the screening performance.

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Section: Ppv Of Cytology For Cin2+mentioning

confidence: 99%

Impact of HPV vaccination on cervical screening performance: a population-based cohort study

et al. 2020

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“…Vaccine effectiveness for CIN2+ has been demonstrated with one, two, and three doses of vaccine. [41][42][43][44][45][46][47][48][49] Given these positive results, interest is increasing in how vaccination programs may reduce the incidence of ICC through herd immunity and achieve the near elimination of cervical cancer. Australia's national human papillomavirus vaccination program started in 2007 for girls aged 12-13 and in 2013 for boys the same age, with catch-up to age 26.…”

Section: Impact Of Human Papillomavirus On Risk Of Cervical Cancermentioning

confidence: 99%

Human papillomavirus vaccination and cervical cancer risk

Rahangdale

Mungo

O’Connor

et al. 2022

BMJ

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Persistent human papillomavirus infection is the central cause of cervical cancer, the leading cause of cancer death among women worldwide. Clear evidence from both randomized trials and population based studies shows that vaccination against human papillomavirus reduces the incidence of cervical pre-cancer. These data suggest that the vaccine reduces the incidence of cervical cancer. However, human papillomavirus vaccine coverage is inadequate in all countries, especially in low and middle income countries where disease burden is highest. Supply side strategies to improve coverage include increasing the availability of low cost vaccines, school located delivery, single dose vaccine schedules, and development of vaccines that do not need refrigeration. Demand side strategies include enhancing provider recommendations, correcting misinformation, and public awareness campaigns. The near elimination of cervical cancer is achievable through increased uptake of human papillomavirus vaccination and efforts to increase screening for cervical cancer, especially when enacted to reduce disparities in across the world.

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“…Only a few studies have analyzed the occurrence of CIN 3/ HSIL after HPV vaccination outside of controlled studies. 23,29,30 With our analysis, we contribute to the knowledge in this field. Considering our results, several patient-specific and general issues can be discussed from our 9 cases: First, in patient #1, HPV 16 was detected.…”

Section: Discussionmentioning

confidence: 94%

Cervical Intraepithelial Neoplasia 3 (Cervical Intraepithelial Neoplasia 3/High-Grade Squamous Intraepithelial Lesion) in Human Papillomavirus–Vaccinated Women—Results From a Tertiary Referral Center

Domröse

Wieland

Pilch

et al. 2022

J Low Genit Tract Dis

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High-grade cervical intraepithelial neoplasia (CIN 3) still develops in some vaccinated women despite established effectiveness of prophylactic human papillomavirus (HPV) vaccination. The purpose of this study was to define characteristics of women with CIN 3 after HPV vaccination referred to a gynecological dysplasia unit.Materials and Methods: Retrospective analysis of HPV-vaccinated women with CIN 3 in a single German center. Between July 2018 and September 2020, 791 women were referred to our university hospital-based dysplasia unit for colposcopic evaluation of abnormal cytological findings. Human papillomavirus vaccination status was retrieved. Human papillomavirus typing was performed in lesional biopsies and cervical swabs.Results: Nine women were identified who had previously been vaccinated with the quadrivalent HPV vaccine (Q-HPV) and were diagnosed with histologically confirmed CIN 3/high-grade squamous intraepithelial lesion. The Q-HPV had been administered between 12 and 28 years of age and 1-13 years before CIN 3 diagnosis. Nine different high-risk (HR)-HPV types were found in the CIN 3 biopsies, 6 monoinfections (twice HPV 16, once HPV 18, HPV 31, HPV 52, HPV 58, respectively) and 3 dual infections (HPV 33 + 52, HPV 51 + 52, HPV 53 + 66). Seven of these 9 HR-HPV types are not covered by Q-HPV, but only 2 CIN 3 lesions carried HR-HPV types not included in the nonavalent HPV vaccine. Conclusions:It is important to implement vaccination recommendations and administer HPV vaccination as early as possible in HPV-naive individuals. Because not all HR-HPV types are covered by the available HPV vaccines, other types may still cause CIN 3/high-grade squamous intraepithelial lesion. This requires further screening after vaccination, especially in women who were previously vaccinated with the bivalent or the quadrivalent HPV vaccine.

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Human papillomavirus types in cervical dysplasia among young HPV‐vaccinated women: Population‐based nested case–control study

Cited by 19 publications

References 27 publications

Impact of HPV vaccination on cervical screening performance: a population-based cohort study

Impact of HPV vaccination on cervical screening performance: a population-based cohort study

Human papillomavirus vaccination and cervical cancer risk

Cervical Intraepithelial Neoplasia 3 (Cervical Intraepithelial Neoplasia 3/High-Grade Squamous Intraepithelial Lesion) in Human Papillomavirus–Vaccinated Women—Results From a Tertiary Referral Center

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