The efficacy of human papillomavirus vaccination in the prevention of recurrence of severe cervical lesions

Authors

  • Borek Sehnal Gynecologic Oncology Center, Department of Gynecology and Obstetrics, Faculty Hospital Bulovka and 1st Medical School of Charles University, Prague. https://orcid.org/0000-0003-2622-2181
  • Tomáš Pichlík
  • Michael J. Halaška
  • Monika Větrovská
  • Anna Babková
  • Jana Drozenová
  • Helena Robová
  • Lukáš Rob

Keywords:

Human papillomavirus, HPV, HPV vaccine, cervical prenacerosis, efficacy, recurrence, vaccination

Abstract

Summary: Objective: A review of current knowledge on the efficacy of human papillomavirus (HPV) vaccination in preventing recurrent severe cervical lesions after excisional surgical treatment. Methods and results: HPV infection is necessary for the development of most cervical precancerous lesions and cervical cancers. Currently, three prophylactic vaccines against HPV infection are available on the market: bivalent Cervarix, quadrivalent Gardasil (formerly Silgard) and nonavalent Gardasil9. All three prophylactic vaccines show high effect in preventing the development of precancerous lesions. The highest efficacy is achieved in the HPV naive population. The surgical excision of severe cervical precancers is the standard approach. However, guidelines regarding HPV vaccination at the time of conisation are not clearly determined. Women diagnosed with severe cervical lesions have mostly not been vaccinated against HPV so far. Therefore, it is beneficial to understand the importance and efficacy of HPV vaccination at the time of conisation in preventing recurrent precancerous lesions. The exact value of HPV vaccination in the context of surgical excision of precancerous lesions remains unclear, but vaccination is definitely valuable in reducing the risk of recurrence. Vaccination timing seems to be more favorable before surgery. However, the ideal timing of vaccination is not established. Some of these questions are likely to be answered by the results of ongoing randomized controlled trials. Conclusion: Adjuvant HPV vaccination in the setting of surgical treatment for cervical precancerous lesion is significantly associated with a reduced risk of recurrence. HPV vaccination should be strongly considered as adjuvant therapy, especially in young patients undergoing conisation for a severe cervical lesion.

Author Biography

Borek Sehnal, Gynecologic Oncology Center, Department of Gynecology and Obstetrics, Faculty Hospital Bulovka and 1st Medical School of Charles University, Prague.

Department of Gynecology and Obstetrics, Gynecologic Oncology Center, Faculty Hospital Bulovka and 1st Medical School of Charles University, Prague.

Published

2023-08-25

Issue

Section

Gynecology and Obstetrics

Categories