A new study confirms that the 9-valent human papillomavirus (HPV) vaccine offers strong protection for women who undergo surgical treatment for precancerous cervical lesions. Researchers at the Comprehensive Cancer Centre of the Medical University of Vienna and the University Hospital Vienna first demonstrated the benefits of the 4-valent HPV vaccine in 2012. The latest analysis now shows that the 9-valent vaccine can significantly lower the risk of disease not only in the cervix but also in the vagina and vulva when administered before surgery. The study was published in the journal Obstetrics & Gynaecology.
Precancerous cervical lesions, medically referred to as high-grade cervical intraepithelial neoplasia, are changes in the cells of the cervix caused by HPV infection. If left untreated, these lesions can progress to invasive cervical cancer. Conisation is the standard treatment for such lesions. The surgical procedure involves removing a cone-shaped section of the cervix to excise abnormal cells. This method allows doctors to carefully examine the tissue and confirm the presence of precancerous changes.
While conisation is effective, it carries certain risks. “Patients who undergo conisation face an increased risk of premature birth in future pregnancies,” explained Elmar Joura, first author of the study and a specialist at MedUni Vienna and University Hospital Vienna. “They also have a higher risk of developing secondary diseases, including several types of cancer.” The study aimed to determine whether prior vaccination with the 9-valent HPV vaccine could reduce the risk of new or recurring disease in the cervix, vagina, and vulva after surgery.
The post-hoc analysis included 1,510 women aged 16 to 26 from a large registration study. Participants were followed for up to six years. The results were clear: women who received the 9-valent HPV vaccine before conisation were significantly less likely to develop new or recurrent HPV-related cell changes. In fact, the probability of a precancerous lesion reappearing after surgery was reduced by up to 90 percent. “In Austria, additional HPV vaccination has become the clinical standard for patients undergoing conisation since 2022,” Joura added. “These findings strongly support that approach.”
HPV is a common virus with more than 200 known types. Certain strains can cause genital warts, while persistent infection with high-risk HPV types can lead to cancers of the cervix, vulva, penis, anus, and even the mouth and throat. The 4-valent HPV vaccine previously used in Austria protected against HPV types 6, 11, 16, and 18. The 9-valent vaccine, in use since 2016, also covers types 31, 33, 45, 52, and 58. Under Austria’s National Immunisation Programme, the vaccine is free for individuals up to 21 years old. Until June 30, 2026, it will also be offered free to those up to 29 if the first dose is administered by December 31, 2025.
This study highlights the growing importance of combining cervical cancer treatment with HPV vaccination. By reducing the risk of recurrent lesions, the vaccine not only protects women’s health but also offers a vital step toward preventing cervical cancer and related diseases.
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