Letters National HPV vaccination

What about vaccinating women with cervical intraepithelial neoplasia against human papillomavirus infection?

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3733 (Published 11 June 2013) Cite this as: BMJ 2013;346:f3733
  1. Neeru Gupta, scientist E1
  1. 1Indian Council of Medical Research, Ansari Nagar, New Delhi-110029, India
  1. neerujani{at}yahoo.co.in

Why doesn’t the Australian national programme include human papillomavirus (HPV) vaccination of those who have undergone cone biopsy for cervical intraepithelial neoplasia (CIN)?1 CIN is usually discovered by a screening test, the Papanicolaou or “Pap” smear, which detects potentially precancerous changes. After removal of the tissue by cryocautery, electrocautery, laser cautery, loop electrical excision procedure, or cone biopsy (which is both therapeutic and diagnostic) the woman is cured of CIN and hence progression to cervical cancer. However, because infection does not give life long immunity against reinfection, the lifetime recurrence rate of CIN is about 20%.2 Therefore, we should not miss the opportunity of vaccinating women who have positive pap smears and have undergone cone biopsy. This would immunise these women against any such recurrence of genital warts or cervical cancer and contribute to herd immunity too.


Cite this as: BMJ 2013;346:f3733


  • Competing interests: None declared.