Introduction/Background The efficacy of HPV vaccination on the risk of recurrent cervical disease related to HPV infection in individuals undergoing local surgical treatment constitutes a matter of debate.

Methodology In this study we screened data sources for studies reporting on the risk of recurrent disease related to HPV infection after local surgical treatment of preinvasive disease in individuals who were vaccinated. Independent and in duplicate data extraction were performed. Pooled risk ratios and 95% confidence intervals were calculated with a random effects meta-analysis model.

Results Eighteen studies reported data from a non-vaccinated group and were included in the meta-analyses. The risk of recurrence of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) was reduced in individuals who were vaccinated compared with those who were not vaccinated (11 studies, 19 909 participants; risk ratio 0.43, 95% confidence interval 0.30 to 0.60; I2=58%, τ2=0.14). The effect estimate was even stronger when the risk of recurrence of CIN2+ was assessed for disease related to HPV subtypes HPV16 or HPV18 (six studies, 1879 participants; risk ratio 0.26, 95% confidence interval 0.16 to 0.43; I2=0%, τ2=0).

Conclusion HPV vaccination might reduce the risk of recurrence of CIN, in particular when related to HPV16 or HPV18, in women treated with local excision. However, large scale high quality randomised controlled trials are required to establish level of efficacy and cost effectiveness.

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Abstract #726 Figure 1

Forest plots assessing CIN2+ recurrence rates between HPV vaccinated and non-vaccinated group after local conservative treatment for CIN irrespective of HPV type

Disclosures The authors declare no conflict of interest with regards to the presented work; a number of authors are investigators of the NIHR EME funded NOVEL trial (MK, KSK, and IK); this trial is also supported by MSD who supplied the vaccines for the trial.