Regional Disparities in the Impact of Human Papillomavirus-Induced Lesions after 10 Years of HPV Vaccination Program in Brazil.

Background and objective: Human papillomavirus (HPV) causes almost all cases of cervical cancer and its prevalence can be significantly reduced by vaccines. This study aimed to compare the prevalence of preneoplastic and neoplastic uterine cervix lesions in the cytology of Brazilian women aged 20-24 yr before and after the HPV vaccination campaign. The study also correlates these findings with the proportional coverage of first and second doses for this population.

Methods: An ecological study was conducted and data from DATASUS were analyzed from 2020 to 2024. Data were collected from women aged 20-24 yr who had oncotic pap smears between 2020 and 2024, and the prevalence ratios (PRs) were calculated in relation to 2020.

Results: Following the vaccination program, the prevalence rate of tests with HPV-induced lesions in Brazil and the north, southeast, and south regions decreased by 0.85, 0.75, and 0.83, respectively, in 2023. No significant reductions were observed in the northeast and central-west regions.

Conclusion: Although the second dose had reduced coverage, HPV-induced lesions were observed to decrease in Brazil and the north, southeast, and south after 10 yr of the beginning of the vaccination program. Decrease in HPV-induced lesions over time after vaccination did not follow similar trend in the northeast or central-west regions as in other parts.