Efficacy and safety of human papilloma virus vaccine in cervical cancer prevention: systematic review and meta-analysis.

INTRODUCTION Cervical cancer is the third most common cancer worldwide. The human papilloma virus (HPV) has been identifed as the etiologic agent of cervical and other anogenital cancers. The aim was to perform a systematic review and meta-analysis to evaluate the efficacy and safety of HPV vaccines in preventing cervical intraepithelial neoplasias (CIN) grades 2 and 3, adenocarcinoma in situ (CIN2+) and cervical cancer. MATERIALS AND METHODS Major bibliographic databases were searched in July 2011 without any temporal nor language restrictions. Randomized controlled trials that evaluated the efficacy of HPV vaccines against CIN2+ and cervical cancer were included. RESULTS Four of the 168 publications found were included in a meta-analysis. Among vaccinated women, the relative risk (RR) of developing CIN2+ lesions was 0.45 (95% CI 0.38 to 0.54) for HPV 16, 0.14 (0.08 to 0.25) for HPV 18, and 0.79 (0.68 to 0.93) for oncogenic serotypes not included in the vaccines 31/33/45/52/58. All studies had acceptable safety profiles. CONCLUSIONS Vaccines currently available are effective, safe and capable of preventing CIN2+ lesions, although long term efficacy has not yet been fully tested.