I just have too much on my plate these days. I meant to get to this earlier, but better later than never. “Population-Based Incidence Rates of Cervical Intraepithelial Neoplasia in the Human Papillomavirus Vaccine Era“:
Importance: A substantial effect of human papillomavirus (HPV) vaccines on reducing HPV-related cervical disease is essential before modifying clinical practice guidelines in partially vaccinated populations.
Objective: To determine the population-based cervical intraepithelial neoplasia (CIN) trends when adjusting for changes in cervical screening practices that overlapped with HPV vaccination implementation.
Design, Setting, and Participants: The New Mexico HPV Pap Registry, which captures population-based estimates of both cervical screening prevalence and CIN, was used to compute CIN trends from January 1, 2007, to December 31, 2014. Under New Mexico Administrative Code, the New Mexico HPV Pap Registry, a statewide public health surveillance program, receives mandatory reporting of all cervical screening (cytologic and HPV testing) and any cervical, vulvar, and vaginal histopathological findings for all women residing in New Mexico irrespective of outcome.
Main Outcome Measures: Prespecified outcome measures included low-grade CIN (grade 1 [CIN1]) and high-grade CIN (grade 2 [CIN2] and grade 3 [CIN3]).
I’ve written many times before about the HPV vaccine, why we give it, and its potential benefits. This study sought to look at the trend of cervical intraepithelial neoplasia (cancer) with respect to the implementation of the HPV vaccine. Researchers used the New Mexico HPV Pap Registry, which collects data on population-based estimated of screening and cancer, from 2007 through 2014. The law in NM mandates reporting on both screening and any findings.
From 2007 to 2014, more than 20,000 lesions were diagnosed in females age 15-29 years old. After adjusting for changes in screening over time, they found that reductions in the incidence of all neoplasias over time were significant. Grade 1 lesions in this group dropped, on average, 9% each year. Grade 2 lesions dropped 10.5%, and Grade 3 lesions dropped a whopping 41.3%.
The number of grade three lesions in females age 15 to 29 years dropped from 240.2 in 2007 to 0 (yes, zero) in 2014.
There’s good news here all over. The first is that the HPV vaccine seems to be working. We’re picking up less and less cancer in women who are screened. This means that we should also consider raising the age for screening even higher.
And this is with the uptake of HPV vaccine being about 40% in this population. If we could get the rate of HPV vaccination up high enough, we might see even better results.