Population-Based First Estimates of the Effect of HPV Vaccination in Three Italian Areas Covered by Organised Cervical Screening
Menée à l'aide de données italiennes portant sur 14 346 femmes nées sur la période 1993-1996, cette étude analyse les taux d'infection par le papillomavirus humain (HPV) et les taux de lésions précancéreuses (CIN2+) en fonction du statut vaccinal contre le HPV
In Italy, the first women invited for HPV vaccination at 15–16 years reached the age for cervical screening (25 years) in 2018. The real-world vaccination impact was evaluated. Women born in 1993–1996 invited for organised cervical screening in three Italian areas in 2018–2022 were eligible. After informed consent, they were tested for high-risk HPV and genotyped. Positives, triaged by cytology, were immediately referred to colposcopy if ASCUS+ (irrespective of genotyping); otherwise, recalled for cytology after 3 years. We estimated the relative (vaccinated with ≥ 2 doses vs. unvaccinated women) infection prevalence of three groups of genotypes: HPV16/18, HPV31/33/45 and HPV 35, 39, 51, 52, 56, 58, 59, 66, 68 (‘non-vaccine preventable’) and the relative positive predictive value (PPV) for histology-based CIN2+ detected at immediate colposcopy. Of 14,346 enrolled women, 34% had no vaccination, 66% ≥ 2 doses. The relative infection prevalence was 0.05 (0.03–0.10) for HPV16/18 without non-vaccine genotypes, 1.36 (1.23–1.50) for non-vaccine genotypes without HPV16/18 infections and 0.06 (0.03–0.12) for co-infections by both groups. The relative PPV for CIN2+ was very high (4.09; 1.40–12.01) in vaccinated women co-infected by HPV16/18 and non-vaccine types (4/9 vs. 7/84 cases) but reduced to zero in case of stand-alone HPV16/18 infections (0/12 vs. 15/117 cases). The CIN2+ relative detection in women infected only by non-vaccine types was 1.57 (0.87–2.82). The increase in infections and high-grade CIN from the pool of all non-vaccine genotypes requires further research (including pooling of data) to be confirmed with longer follow-up and on a larger study population.
International Journal of Cancer , résumé, 2026