Early and long-term effects of prophylactic and post-excision human papillomavirus vaccination on recurrent high-grade cervical intraepithelial neoplasia relative to margin status: a retrospective cohort study in the Czech Republic
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View abstract on PubMed
Summary
This summary is machine-generated.Human papillomavirus (HPV) vaccination significantly reduces the recurrence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). The benefits are most pronounced within six months post-conisation, especially for women with positive cone margins.
Area Of Science
- Gynecology
- Oncology
- Immunology
Background
- Cervical intraepithelial neoplasia grade 2 or worse (CIN2+) requires treatment, often conisation.
- The impact of human papillomavirus (HPV) vaccination on CIN2+ recurrence, particularly concerning cone margin status and timing of vaccination, remains unclear.
- Existing research often overlooks early recurrence patterns post-conisation.
Purpose Of The Study
- To investigate the effect of HPV vaccination on CIN2+ recurrence after conisation.
- To determine if the timing of HPV vaccination (prophylactic vs. post-conisation) influences recurrence rates.
- To assess the impact of cone margin status on vaccination effectiveness against recurrence.
Main Methods
- A cohort study in the Czech Republic analyzed data from 10,054 women treated for CIN2+ between 2010 and 2024.
- Women received either prophylactic HPV vaccination or vaccination post-conisation.
- Incidence rate ratios (IRR) from Poisson regression models were used to estimate vaccination effects, with results presented as percentage reduction (100 × (1-IRR)).
Main Results
- HPV vaccination reduced CIN2+ recurrence by 54% (prophylactic) and 74% (post-conisation) overall.
- Within six months post-conisation, prophylactic vaccination showed an 80% reduction, and post-excision vaccination an 89% reduction in recurrence.
- In women with positive cone margins, prophylactic vaccination reduced recurrence by 62%, and post-excision vaccination by 79%.
Conclusions
- HPV vaccination, regardless of timing, offers significant long-term protection against CIN2+ recurrence.
- Post-excision vaccination demonstrated a greater reduction in recurrence compared to prophylactic vaccination, though not statistically significant.
- The most substantial benefits of HPV vaccination were observed in the early period (within six months) after conisation, particularly for women with positive cone margins.
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