Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland.

Publisher: Nature Publishing Group on behalf of Cancer Research UK Country of Publication: England NLM ID: 0370635 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-1827 (Electronic) Linking ISSN: 00070920 NLM ISO Abbreviation: Br J Cancer Subsets: MEDLINE

Publication: 2002- : London : Nature Publishing Group on behalf of Cancer Research UK
Original Publication: London, Lewis.

Papillomavirus Infections/*prevention & control ; Papillomavirus Vaccines/*therapeutic use ; Uterine Cervical Dysplasia/*prevention & control ; Uterine Cervical Neoplasms/*prevention & control; Adult ; Cohort Studies ; Colposcopy ; Female ; Follow-Up Studies ; Humans ; Mass Screening ; National Health Programs ; Neoplasm Grading ; Papillomaviridae/isolation & purification ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/pathology ; Papillomavirus Infections/virology ; Prevalence ; Prognosis ; Scotland/epidemiology ; Uterine Cervical Dysplasia/epidemiology ; Uterine Cervical Dysplasia/pathology ; Uterine Cervical Dysplasia/virology ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/virology ; Vaccination ; Vaccine Potency ; Vaginal Smears ; Young Adult

Background: In Scotland, a national HPV immunisation programme began in 2008 for 12- to 13-year olds, with a catch-up campaign from 2008 to 2011 for those under the age of 18. To monitor the impact of HPV immunisation on cervical disease at the population level, a programme of national surveillance was established.
Methods: We analysed colposcopy data from a cohort of women born between 1988 and 1992 who entered the Scottish Cervical Screening Programme (SCSP) and were aged 20-21 in 2008-2012.
Results: By linking datasets from the SCSP and colposcopy services, we observed a significant reduction in diagnoses of cervical intraepithelial neoplasia 1 (CIN 1; RR 0.71, 95% CI 0.58 to 0.87; P=0.0008), CIN 2 (RR 0.5, 95% CI 0.4 to 0.63; P<0.0001) and CIN 3 (RR 0.45, 95% CI 0.35 to 0.58; P<0.0001) for women who received three doses of vaccine compared with unvaccinated women.
Conclusions: To our knowledge, this is one of the first studies to show a reduction of low- and high-grade CIN associated with high uptake of the HPV bivalent vaccine at the population level. These data are very encouraging for countries that have achieved high HPV vaccine uptake.

Comment in: Nat Rev Urol. 2014 Nov;11(11):605. (PMID: 25245243)

Vaccine. 2013 Feb 4;31(7):1051-6. (PMID: 23277094)
J Natl Cancer Inst. 2014 Mar;106(3):djt460. (PMID: 24552678)
BMJ Open. 2012 Sep 25;2(5):. (PMID: 23012329)
J Epidemiol Community Health. 2003 Jun;57(6):417-23. (PMID: 12775786)
J Natl Cancer Inst. 2011 Oct 5;103(19):1444-51. (PMID: 21908768)
Br J Cancer. 2007 Sep 3;97(5):691-4. (PMID: 17687335)
J Epidemiol Community Health. 2014 Jan;68(1):57-63. (PMID: 23986492)
BMC Infect Dis. 2013 Nov 05;13:519. (PMID: 24188790)
Br J Cancer. 2014 May 27;110(11):2804-11. (PMID: 24736582)
Vaccine. 2013 Mar 25;31(13):1673-9. (PMID: 23375978)
Lancet. 2009 Jul 25;374(9686):301-14. (PMID: 19586656)
Vaccine. 2012 Dec 17;31(1):109-13. (PMID: 23137842)
J Med Screen. 2011;18(1):41-5. (PMID: 21536816)
BMJ. 2014 Mar 04;348:g1458. (PMID: 24594809)
Lancet Infect Dis. 2012 Oct;12(10):781-9. (PMID: 22920953)
Br J Cancer. 2011 Mar 29;104(7):1221-6. (PMID: 21343934)
Hum Vaccin. 2011 Dec;7(12):1374-86. (PMID: 22048171)
Lancet Oncol. 2012 Jan;13(1):100-10. (PMID: 22075170)
Int J Cancer. 2007 Aug 1;121(3):621-32. (PMID: 17405118)
Br J Cancer. 2010 Mar 2;102(5):930-2. (PMID: 20145611)
Lancet. 2011 Jun 18;377(9783):2085-92. (PMID: 21684381)

CZB/4/658 United Kingdom CSO_ Chief Scientist Office; CZH/4/528 United Kingdom CSO_ Chief Scientist Office

0 (Papillomavirus Vaccines)

Date Created: 20140903 Date Completed: 20150109 Latest Revision: 20221207

20240829

PMC4453734

10.1038/bjc.2014.479

25180766