Can the HPV Vaccine Reduce Cervical Lesion Recurrence?

According to this study, women with high-grade cervical intraepithelial neoplasia (CIN) are particularly sensitive to HPV infection and can reacquire an infection even after local surgical treatment. However, the HPV vaccine is more immunogenic than an HPV infection.

"The body's immune system responds more robustly to create immune protection from the vaccine than it does to the actual virus itself," explained Troy Gatcliffe, M.D., a gynecologic oncologist at Miami Cancer Institute.

Peter Sasieni, professor of cancer prevention at King's Clinical Trials Unit in London and an author of the study, explained that almost all cases of high-grade CIN are caused by HPV. The HPV vaccine protects against the most common types of HPV.

"If a woman is vaccinated before being infected with HPV, she will be protected against infection. Without infection, she will not develop high-grade CIN," Sasieni said.

However, the research is still unclear about whether vaccination against HPV reduces recurrence of CIN caused by the same type of HPV. Some observational studies have found a reduction in the recurrence of high-grade CIN in up to 80 percent of women who were vaccinated at the time of treatment. Other studies suggest no benefit.

While it's well known that HPV vaccination reduces rates of high-grade CIN, less is known about whether it has an effect on recurrent infections. This study aims to find out the answer. On the one hand, the study reaffirms the benefit of HPV vaccination.

"If the protection of vaccination continues to last as women go into their 30s and 40s, vaccination looks set to prevent 80 percent of cervical cancer," Sasieni explained.

On the other hand, we still don't have conclusive evidence on how vaccination protects against recurrent infections in women with CIN.

The articles reviewed in the study ultimately showed that the data is inconclusive and more large-scale, high-quality, randomized controlled trials are needed for a more definitive answer.

"It is not clear that HPV vaccination in this particular group of women is unequivocally effective at preventing CIN recurrence," Gatcliffe said.

However, it's still important for all young women, regardless of their cancer risk, to get vaccinated against HPV.

Additional research is ongoing to find out more about HPV vaccination and its protective effects against CIN. The NOVEL (Nonavalent Prophylactic HPV Vaccine After Local Conservative) trial is a large, randomized controlled trial that is expected to give further insight into the effects of Gardasil 9 (an HPV vaccine) on incidence, recurrence and prevalence of HPV infections. The results have the potential to be beneficial to women with malignancies associated with HPV infection, such as CIN.

It's also unclear how long the HPV vaccine's beneficial effects last.

"We are looking at to what extent women from different socioeconomic groups benefit from HPV vaccination and also whether there is any evidence of waning efficacy," Sasieni said.

At the time of vaccination, men and women usually receive a total of two or three doses, depending on age. Revaccination is not required.

Current recommendations suggest that all young men and women should be vaccinated against HPV. This is especially true for women with a family history of cervical cancer. If you're unsure, talk to your doctor about the risks and benefits of the HPV vaccine to learn more.