Vulvar and vaginal precancerous lesions decreased after the introduction of the HPV vaccine

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January 06, 2022

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The rates of high-grade vulvar, vaginal and anal precancerous diseases have declined or stabilized after the introduction of the HPV vaccine, according to results published in the journal American Journal of Preventive Medicine.

“HPV causes almost all types of cervical cancer and a large proportion of vaginal, vulvar and anal cancers.” Mona Saraiya, MD, MPH, a medical officer and team leader in the Epidemiology and Applied Research Division of the CDC’s Cancer Prevention and Control Division, and colleagues wrote.

Mixing JM et al. Am J Prev Med. 2022; doi: 10.1016 / j.amepre.2021.06.026.

Vaccine-type HPV infections, anogenital warts, cervical cancer precursors, and invasive cervical cancer have decreased in the US since the launch of the HPV vaccine in girls in 2006 and boys in 2011, they added.

Saraiya and colleagues examined the incidence rates of grade 3 intraepithelial lesions, vulvar, vaginal, and anal precancerous lesions in subjects aged 15 to 39 years. Using data from 2000 to 2017 from select cancer registries, the data covered 27.8% of the US population requiring reporting of these precancerous lesions.

During the study period there were a total of 6,128 vulvar, 945 vaginal and 462 anal precanceroses in women and 2,154 anal precanceroses in men. After the introduction of the HPV vaccine, the rates of high-grade vulvar precursors after the introduction of the HPV vaccine decreased by 21% per year in women ages 15-19 and 11.2% per year in women ages 20-24 Years and 7.6% per year for women aged 25 to 29 years. According to the researchers, rates of high-grade vaginal precancerous lesions decreased 19.1% per year in women ages 15-19 and decreased 5.6% per year in women 30-39 years of age.

Prior to the introduction of the vaccine, the rates of high-grade anal precancerous lesions increased. However, after the vaccine was introduced, anal precancerous rates stabilized in women ages 15 to 29 and in men ages 30 to 39, observed Saraiya and colleagues. However, in men aged 15 to 29, the rate of precancerous lesions of the anal area increased by 35% from 2000 to 2007 and by 7% from 2007 to 2017.

Most cases of vulvar and vaginal precancer were found in women aged 30 to 39 years (62.8% and 60.7%, respectively) and non-Hispanic white women (64.6% and 61.1%, respectively). Saraiya and colleagues also observed that most cases of anal precancerous lesions were found in women and men ages 30 to 39 years (77.9% and 77.1%, respectively) and non-Hispanic white women and men (55.8% and 46%) were discovered.

The decline in vulvar and vaginal precancerous lesions “in younger age groups is analogous to the declines seen in cervical cancer attributed to the introduction of the HPV vaccine,” wrote Saraiya and colleagues.

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