When clinical practice guidelines in cervical cancer screening are reassessed, decreases in cervical intraepithelial neoplasia (CIN) on the population level among patients vaccinated for the human papillomavirus (HPV) should be considered, according to a study published in JAMA Oncology.1

Researchers led by Vicki Benard, PhD, of the Centers for Disease Control and Prevention in Atlanta, GA, evaluated 13,520 cases of CIN1, 4,296 cases of CIN2, and 2823 cases of CIN3 lesions through the New Mexico HPV Pap Registry to determine CIN trends when adjusting for potential changes in screening practices.

Upon adjusting for changes in cervical screening across the study period of January 2007 to December 2014, the researchers found that CIN incidence was reduced significantly per 100,000 women screened across all grades of CIN among patients who were 15 to 19 years old, from 3468.3 to 1590.6 for CIN1, 896.4 to 414.9 for CIN2, and 240.2 to 0 for CIN3.


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Reductions in the incidence of CIN2 were significant among women aged 20 to 24 years old, from 10.27.7 to 627.1.

“Evidence is rapidly growing to suggest that further increases in raising the age to start screening are imminent, one step toward integrating screening and vaccination,” the authors conclude.

Reference

  1. Benard VB, Castle PE, Jenison SA, et al. Population-based incidence rates of cervical intraepithelial neoplasia in the human papillomavirus vaccine era. JAMA Oncol. 2016 Sep 26. doi:10.1001/jamaoncol.2016.3609 [Epub ahead of print]