TITLE:
Evolution of Cervical Lesions Associated with Human Papillomavirus Infection after the Introduction of Vaccination
AUTHORS:
Montserrat de la Torre, Ana María Colino, Lone Nielsen, Alejandro Pascual, Concepción Millana, María Jesús González, Patricia Barreiro, Eva Rodríguez, Dolores García, Aranzazu Gómez, Rosa Rodero, María Jesús Fernández
KEYWORDS:
HPV, Serotypes, Cervix, Vaccine, CIN 2 - 3, Squamous Cell Carcinoma, Women’s Health
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.8,
August
9,
2023
ABSTRACT: Background: The main objective of this study is to analyse the change in the type of lesions
developed by HPV-infected patients after the introduction of the vaccine in three
different periods; 2002-2006 (years previous to the implementation of the vaccine
in Spain), 2009-2011 (shortly after the vaccination) and 2020-2021 (years where
the vaccine was well established) at a single hospital. Methods: This is
an observational, descriptive, retrospective study based on the review of the results
of the biopsies of patients with HPV lesions at a single large tertiary hospital,
Hospital Clínico San Carlos, in Madrid, Spain. We have collected the data from three
different time periods: 2002-2006, 2009-2011, 2020-2021 to try to understand the
potential changes in these lesions after vaccine introduction. Results: In
this time we have reviewed the data from 946 women. In these three periods, a decreasing
trend in the rate of squamous cell carcinoma was noted, the rate of adenocarcinoma
remains stable, and the rate of cervical intraepithelial neoplasia grades 2 - 3 (CIN 2-3) lesions shows an increasing trend. We have also found a change in the mean
ages of the patients with these lesions, as this increased in the three lesions
caused by HPV after the implementation of the vaccine. Our study indicates that
the identification of other high risk serotypes, apart from 16 and 18, as well as
those with indeterminate risk, has undergone a progressive increase, increasing
from 24.24% and 14.11% respectively in 2002-2006 to 40.42% and 28.34% in 2020-2021. Conclusion: Our study confirms the effectiveness of the vaccines developed so far,
against the HPV serotypes they contain. This is demonstrated by the evidence,
in our population, of a decrease in the incidence of squamous cell carcinoma in
uterine cervix. In parallel, an increase in the mean age of diagnosis has been
verified, for both squamous cell carcinoma and its CIN 2-3 precursor lesions, as well
as a change in the infective trend of HPV serotypes that are not included in
the current vaccines.