Cervical cancer: the key role of the HPV vaccine after surgery

Cervical cancer: the key role of the HPV vaccine after surgery

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THE ESSENTIAL

  • It is not always necessary to treat a precancerous lesion of the cervix.
  • Depending on its severity, the lesion can be monitored until it heals spontaneously (which happens most often) or removes it (the National Institute against Cancer (Inca)

Caution is advised, but this discovery could represent a real breakthrough in the fight against cervical cancer.

Ranking officer

Currently, women who have had surgery to remove “high-grade” precancerous lesions of cervical cancer have a high residual risk of relapses and other malignancies linked to human papillomavirus (HPV) infection. ).

We speak of “high grade” CIN 2 when the lesions affect two thirds of the epithelium – the tissue that covers the cervix – and CIN 3 when they affect the entire thickness of the epithelium.

But English researchers from Imperial College London have just demonstrated the potentially protective role of the vaccine against HPV associated with this surgery.

In their study published in the British Medical Journal, they suggest that giving women a dose at the time they undergo surgery to remove pre-cancerous cells could prevent recurrence.

Vaccination against HPV is very effective in preventing the development of precancerous cervical lesions (cervical intraepithelial neoplasia or CIN)”, they explain.

Reduced by 57%

The researchers analyzed the results of 22 studies which showed that the risk of recurrence of “high-grade preinvasive disease” (CIN2+) was reduced by 57% in those vaccinated against the papillomavirus at the very moment when their precancerous cells are removed. A percentage obtained in comparison to those who were not vaccinated.

A reduction was even greater – 74% – when the risk of CIN2+ recurrence was assessed for diseases related to the two high-risk HPV types (HPV16 and HPV18). These papillomaviruses are in 70% of cases responsible for cancers of the cervix.

The risk of recurrence of CIN3 was also reduced in vaccinated patients, but the uncertainty was high since only three studies mentioned it.

The researchers pointed out that currently there is a high level of uncertainty about the quality of the evidence and more large-scale studies need to confirm that vaccination does confer this benefit in women who have undergone surgery.

100%

With regard to the vaccine against HPV, its effectiveness is now recognized. When administered before the onset of sexual life, the effectiveness of vaccination is close to 100%.

In France, it has been recommended since 2007 for all young girls. Since January 1, 2021, boys can also be vaccinated.

In addition to vaccination, the fight against cancer of the cervix also involves screening, via regular Pap smears – every three years for women aged 25 to 65 – to identify precancerous lesions and early-stage cancers. An examination to be done even for those vaccinated against HPV.


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