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. 2021 Feb;128(3):532-539.
doi: 10.1111/1471-0528.16429. Epub 2020 Aug 10.

Human papillomavirus vaccine effectiveness within a cervical cancer screening programme: cohort study

C Acuti Martellucci  1 , S Nomura  1 , D Yoneoka  1   2 , P Ueda  1 , Jml Brotherton  3   4 , K Canfell  5   6 , M Palmer  1   4 , L Manzoli  7 , P Giorgi Rossi  8 , A De Togni  9 , C Palmonari  9 , A Califano  9 , E Saito  10 , M Hashizume  1 , K Shibuya  1
Affiliations

Human papillomavirus vaccine effectiveness within a cervical cancer screening programme: cohort study

C Acuti Martellucci et al. BJOG. 2021 Feb.

Abstract

Objective: To assess the effectiveness of an HPV vaccination programme in reducing the risk of cervical abnormalities identified at subsequent screening.

Design: Retrospective cohort study using administrative health data.

Setting: General population of Ferrara Province, Italy.

Population: Female residents born in 1986-1993 and participating in the organized cervical screening programme in 2011-2018, who were eligible for HPV vaccination in catch-up cohorts.

Methods: Logistic regression to evaluate the potential association between abnormal cervical cytology and one, two, three or at least one dose of HPV vaccine.

Main outcome measures: Cervical abnormalities, as predicted by low-grade or high-grade cytology, by number of vaccine doses, stratified by age.

Results: The sample consisted of 7785 women (mean age 27.5 years, SD 2.3). Overall, 391 (5.0%) were vaccinated with ≥1 dose and 893 (11.5%) had abnormal cytology. Women receiving at least one vaccine dose were significantly less likely to have an abnormal cytology (adjusted odds ratio 0.52; 95% confidence interval 0.34-0.79). Similar results were observed for women receiving a single dose, for both bivalent and quadrivalent vaccines, and applying buffer periods (excluding cytological outcomes within 1 month, 6 months and 1 year of the first dose).

Conclusions: In the context of an organised cervical screening programme in Italy, catch-up HPV vaccination almost halved the risk of cytological abnormalities.

Tweetable abstract: Among Ferrara women, vaccination against human papillomavirus halved the risk of screening cervical abnormalities.

Keywords: Cervical screening; human papillomavirus; vaccine.

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