Is it the time to include transgender women in risk groups for human papillomavirus vaccination?

Dominguez-Riscart, Jesus; Mateo-Gavira, Isabel; Martin-Aspas, Andres

doi:10.1016/j.vacune.2022.10.001

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Vaccination of the population was primarily designed to protect people from cervical cancer, however recent scientific evidence shows it can protect against other neoplastic entities.<a class="elsevierStyleCrossRef" href="#bb0005">1</a>The Spanish HPV vaccination schedule has been systematically implemented for adolescent girls under 14 years of age since 2008. Different societies have been supporting the expansion of the vaccinated population, as per the recommendations approved by the Vaccination Committee of the Spanish Paediatric Association, which advocates the systematic inclusion of adolescent boys under 14 years of age.<a class="elsevierStyleCrossRef" href="#bb0010">2</a> Although other countries and some autonomous communities in Spain had already taken other indications into account, the Interterritorial Council of the National Health System has included different risk groups for the prevention of HPV-associated diseases since 2018, such as people in prostitution, men who have sex with men, women who have undergone conization, and women with haematopoietic transplants, all under 26 years of age, as well as women with solid organ transplants, without specifying an age limit.<a class="elsevierStyleCrossRef" href="#bb0015">3</a> However, transgender women are left out of these indications, possibly because there was insufficient supporting evidence, although recent studies have been published that may support this need.Studies have shown a high prevalence of high-risk serotypes and the presence of anogenital warts in this population. For example, in a cohort of 68 transgender women in Peru, up to 95.6% had HPV infection, 58.8% were high-risk, and up to 19.1% had anogenital warts.<a class="elsevierStyleCrossRef" href="#bb0020">4</a> Something similar was reported in a cohort of 272 Brazilian transsexuals where it was found that up to 77.9% of the women were infected by HPV, and 60.7% were at high risk.<a class="elsevierStyleCrossRef" href="#bb0025">5</a>We should also take into account a study conducted in the United States which reports that transgender women have a higher prevalence of anal HPV infection than men who have sex with men, 88.6% versus 70.9%, respectively.<a class="elsevierStyleCrossRef" href="#bb0030">6</a>Women with neovaginas, after gender reassignment surgery, present cytological characteristics similar to a normal vagina with a risk of developing precancerous lesions, and therefore screening is indicated to prevent them.<a class="elsevierStyleCrossRef" href="#bb0035">7</a> In addition, 5 cases of squamous cell carcinoma related to HPV infection of the neovagina have been reported in transsexual women.<a class="elsevierStyleCrossRef" href="#bb0040">8</a>,<a class="elsevierStyleCrossRef" href="#bb0045">9</a>This should make us consider the inclusion of transgender women in the criteria for HPV rescue vaccination. It would also help us continue with the process of depathologisation and consider the specific needs of this population, as it would have considerable impact on their health.FundingThis research study has not received specific funding from public sector agencies, commercial sector, or non-profit organisations.Conflict of interestsThe authors have no conflict of interests to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "s1025" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "s2025" "titulo" => "Conflict of interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Dominguez-Riscart J, Mateo-Gavira I, Martin-Aspas A. ¿Es el momento de incluir a las mujeres transexuales como grupo de riesgo para la vacunación frente al virus del papiloma humano? 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Official journal of the Asociación Española de Vacunología (AEV) Vacunas is a peer-reviewed journal supported by an advisory board of experts in the field of vaccinology. The aim of the journal is to contribute to the dissemination of the scientific advances made in the area of basic and applied research in the field of vaccine-preventable diseases in humans. It places special emphasis on aspects associated with planning and evaluation (epidemiology of vaccine-preventable diseases, development of vaccination programs, evaluation of the efficacy, effectiveness and efficiency of vaccinations). Vacunas publishes, in Spanish and in English, Editorials, Original Articles, Special Articles, Reviews, Strategies and Vaccination Programs. There are also sections on Literature Reviews, News and on Congresses associated with vaccinations. The peer review process is done anonymously by reviewers with expertise in the area of knowledge of each manuscript as well as experts in methodology or statistics, as determined by the Editorial board, which works towards maintaining an efficient editorial process in order for the manuscripts to be published as soon as possible.

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Vol. 23. Issue 3.

Pages 243-244 (September - December 2022)

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