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Effective implementation of nine-valent HPV vaccination could prevent majority of cervical cancers
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Most cervical precancers appear to be caused by one of nine types of HPV, according to study results.
The findings suggest an investigational nine-valent HPV vaccine — manufactured by Merck and currently under review by the FDA — could prevent cervical cancers more effectively than current vaccines, according to study results.
“We wanted to study how many cervical precancers could potentially be prevented by an investigational nine-valent HPV vaccine that provides protection against the HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58,” researcher Elmar A. Joura, MD, associate professor of gynecology at Medical University of Vienna in Austria, said in a press release. “Approximately 85% or more of precancerous lesions of the cervix were attributed to the nine HPV types covered in the vaccine; therefore, if nine-valent HPV vaccination programs are effectively implemented, the majority of these lesions could be prevented.”
Elmar A. Joura
HPV types 16 and 18 remain the predominant cause of cervical precancers. However, in 2011, the International Agency for Research on Cancer expanded the carcinogens list to include 10 other HPV types.
To assess prevalence and incidence of HPV types, as well as how these types attributed to cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ, Joura and colleagues examined data from 12,514 women aged 15 to 45 years who were enrolled in the placebo arms of three clinical trials of a quadrivalent HPV vaccine.
The researchers evaluated the collective incidence of persistent infection, the proportion of CIN/ adenocarcinoma in situ linked to specific carcinogenic HPV genotypes, and the proportion of CIN/adenocarcinoma in situ lesions that may be prevented by administering a nine-valent HPV vaccine.
Results showed the cumulative incidence of persistent infection with ≥1 of seven high-risk types included in the nine-valent vaccine was 29% for women aged 15 to 26, 12% among women aged 15 to 26, and 6% among women aged 35 to 45 years.
After correcting for lesions with multiple-type infections, researchers identified these seven high-risk types as the cause of 43% to 55% of CIN1, 70% to 78% of CIN2, 85% to 91% of CIN3, and 95% to 100% of adenocarcinoma in situ lesions.
“If vaccination programs with this new generation vaccine are effectively implemented, approximately 90% of invasive cervical cancer cases worldwide could be prevented, in addition to the majority of precancerous lesions,” Joura and colleagues wrote. “However, despite the clear safety profile of the currently disseminated HPV vaccines, uptake in the United States and other resource-rich countries has been inadequate. To achieve the population level potential of the HPV vaccine to reduce cancer, vaccine uptake must increase.”
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.
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