Cervical precancer incidence falls 80% among women most likely to be vaccinated for HPV
Key takeaways:
- Cervical precancer incidence fell 79% and higher-grade precancer incidence decreased 80% among screened women aged 20 to 24 years.
- The data support CDC recommendations to vaccinate children against HPV.
From 2008 to 2022, the incidence of cervical precancers fell by 80% among screened women aged 20 to 24 years, supporting recommendations for HPV vaccination at ages 11 to 12 years, researchers wrote in Morbidity and Mortality Weekly Report.
“These findings reinforce the importance of routine childhood vaccination against HPV infection,” Jasmine Reed, media and public affairs team lead for the CDC’s National Center for Immunization and Respiratory Diseases, told Healio.
HPV is the most common sexually transmitted infection, with one analysis indicating a global prevalence of 31% for HPV overall and 21% for high-risk HPV. The CDC began recommending the HPV vaccination in 2006 to prevent cancers and other diseases caused by HPV, and vaccination coverage has increased steadily through 2021, Julia W. Gargano, PhD, an academic researcher with the CDC’s National Center for Immunization and Respiratory Diseases, and colleagues wrote in the study background.
“CDC has monitored incidence of precancerous lesions ... which are detected through cervical cancer screening and can be used as an intermediate outcome for monitoring vaccination impact, via the five-site Human Papillomavirus Vaccine Impact Monitoring Project,” the researchers wrote.
Researchers analyzed trends in precancerous lesion incidence from 2008 through 2022 among women aged 20 to 64 years in the Human Papillomavirus Vaccine Impact Monitoring Project (HPV-IMPACT) catchment areas, stratified by 5-year age group. Researchers estimated the proportions of women screened via a Pap or HPV test in the preceding year by multiplying age-specific proportions screened by age-specific populations of women. Data from 2020 were excluded from the analyses due to the COVID-19 pandemic.
Among women aged 20 to 24 years screened for cervical cancer, the rate for cervical intraepithelial neoplasia grade 2 or higher (CIN2+) fell by 79% and the rate for CIN3+ fell by 80%. During the same 2008-2022 period, CIN3+ incidence rates among screened women aged 25 to 29 years also decreased by 37%.
“These data are consistent with considerable impact of HPV vaccination for preventing cervical precancers among women in the age groups most likely to have been vaccinated and support existing recommendations to vaccinate children at the routinely recommended ages as a cancer prevention measure,” the researchers wrote.
The researchers noted that some women aged 30 to 34 years and older have received the HPV vaccine, but this age group was only eligible for “catch-up” vaccination during a time when many women are already sexually experienced and therefore likely to have been infected with HPV.
“The data also suggest that precancer incidence in age groups 25 years, which were previously observed to increase through 2015, have begun to decrease,” the researchers wrote. “HPV vaccination and guidelines-based cervical cancer screening are important tools for cervical cancer prevention.”
The data follow a similar report recently published in JAMA, reported by Healio, which showed cervical cancer mortality among U.S. women younger than 25 years declined by 62% between 2013 and 2021, a finding largely attributed to the wide availability of HPV vaccination for this age cohort.
Perspective
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The HPV-IMPACT study included in the CDC’s Morbidity and Mortality Weekly Report provides strong data behind the positive impact HPV vaccination has in preventing high-risk HPV among people aged 20 to 24 years. This additional data clearly points to the importance of early HPV vaccination, starting as early as age 9 years but generally around ages 11 or 12 years. Fewer high-risk HPV infections were detected among women aged 24 to 29 years who were old enough to have received the vaccine. Public health and scientific data are emerging every day linking HPV to not just cervical but oropharyngeal, anus, penile and other cancers. Timely vaccination among boys and girls and men and women is paramount as a means of cancer prevention.
Although the vaccine has been available since 2006, the lack of awareness that it can prevent cancer in later life has slowed progress in preventing these cancers. The CDC estimates that timely HPV vaccination could prevent 90% of cervical cancers alone, and only about half (56.9%) of children who qualify for the vaccine have received it. Among them, more girls and women are being vaccinated than boys and men.
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