Rates of Precancerous Cervical Lesions Declining in Young Women

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The recent decline in cervical intraepithelial neoplasia grade 2, 3, and adenocarcinoma in situ (CIN2+) lesions were likely due to reduced screening and potentially human papillomavirus (HPV) vaccination, according to an article published online in the journal Cancer.

There were 9,119 cases of CIN2+ reported to the HPV-IMPACT Project (a monitoring system for the population impact of HPV vaccine) between 2008 through 2012.

These young women were between the ages of 18 to 39 years and residents of catchment areas in California, Connecticut, New York, and Oregon.

Results showed that from 2008 to 2010, women 18 to 20 years had a significantly decreased incidence of CIN2+ lesions (California, from 94 to 5 per 100,000 women; Connecticut, from 450 to 57 per 100,000 women; New York, from 299 to 43 per 100,000 women; and Oregon, from 202 to 37 per 100,000 women; Ptrend <0 .0001).

Women between 21 to 29 years in Connecticut and New York also had a decreased incidence of CIN2+ (from 762 to 589 per 100,000 women and from 770 to 465 per 100,000 women, respectively; Ptrend < 0.001). The rates for women 30 to 39 years did not differ.  

Furthermore, screening rates were found to have declined among the age groups. The largest decrease was among women 18 to 20 years (from 67% in Oregon to 88% in California).

Smaller declines were observed among the 21 to 29 age group and the 30 to 39 age group (13%-27% compared to 3% - 21%, respectively).

The Oncotype DX DCIS Score accurately predicts recurrence risk for patients treated with BCS.
Recent decline in cervical intraepithelial neoplasia and adenocarcinoma in situ lesions were likely due to reduced screening.
Cervical intraepithelial neoplasia grade 2, 3, and adenocarcinoma in situ (CIN2+) lesions can be monitored as early indicators of human papillomavirus (HPV) vaccine impact. 
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