Decline in high grade cervical lesions in US women

The incidence of high grade cervical lesions in young women in the United States has fallen, a new analysis has found. Susan Hariri and her colleagues reported in the journal Cancer that this may be caused by the introduction of the human papillomavirus (HPV) vaccine but may also be due to changes in screening guidelines.

From 2008 to 2012, 9119 cases of high grade cervical lesions (CIN2+) were reported among 18 to 39 year olds as part of a sentinel system for the US Centers for Disease Control and Prevention.

In all four catchment areas the researchers found a dramatic and consistent decrease in the incidence of high grade lesions among women aged 18 to 20 over the study period.

In California the incidence fell from 94 in 100 000 to 5 in 100 000

In Connecticut it fell from 450 to 57 in 100 000

In New York it fell from 299 to 43 in 100 000

In Oregon it fell from 202 to 37 in 100 000.

No change was seen among 30 to 39 year olds.

Vaccination against HPV has been available in the US since 2006. It is offered to girls aged 9 to 12 and as part of short term catch-up scheme targeting 13 to 26 year olds. The picture is unclear, however, as the recommended age for initiating cervical cancer screening was raised to 21 years during the same period, and screening intervals have been extended.

The study concluded that the declines in CIN2+ detection in young women were likely due to reduced screening but could also reflect the impact of vaccination. 

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