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. 2021 Mar 16;13(3):486.
doi: 10.3390/v13030486.

A Retrospective Cohort Study of Young Women Spontaneously Choosing to Be Vaccinated against HPV: Outcomes from Their First Cervical Cancer Screening Test

Annarosa Del Mistro  1 , Jessica Battagello  2 , Luca Weis  1   3 , Vittoria Bressan  4 , Vittorio Selle  5 , Mauro Ramigni  6 , Alessandra Dal Zotto  7 , Antonio Maggiolo  8 , Silvia Gori  1 , Helena Frayle  1 , Marco Zappa  9 , Manuel Zorzi  2 , The Consensus Study Veneto Working Group
Affiliations

A Retrospective Cohort Study of Young Women Spontaneously Choosing to Be Vaccinated against HPV: Outcomes from Their First Cervical Cancer Screening Test

Annarosa Del Mistro et al. Viruses. .

Abstract

Background: Efficacy for cervical cancer prevention of opportunistic HPV vaccination in post-pubertal girls is lower than in 11-year-olds.

Methods: Women born between 1986 and 1992 vaccinated at 15-25 years of age (at least one dose of 4-valent HPV vaccine) and screened at 24-27 years of age were included. Frequency of opportunistic vaccination, overall and by birth cohort, was calculated; screening outcomes were compared between vaccinated and unvaccinated women.

Results: Overall, 4718 (4.9%) HPV-vaccinated, and 91,512 unvaccinated, women were studied. The frequency of vaccination increased by birth cohort, ranging between 1.8% and 9.8%; age at vaccination decreased progressively by birth cohort (p < 0.0001). Participation in screening was 60.8% among vaccinated, and 56.6% among unvaccinated, women (p < 0.0001). Detection rates (DR) for high-grade lesions were lower in vaccinated women (2.11‰ vs. 3.85‰ in unvaccinated, for CIN3+, p = 0.24; 0.0‰ vs. 0.22‰ for cancer). The DR of CIN3+ increased with age at vaccination, scoring respectively 0.0‰, 0.83‰, and 4.68‰ for women vaccinated when they were 15-16, 17-20, and 21-25 years old (p = 0.17).

Conclusions: In comparison to unvaccinated women, higher compliance with cervical cancer screening invitation and lower CIN3+ DR among vaccinated women was observed. Age at vaccination was inversely correlated to vaccination efficacy.

Keywords: CIN2; CIN3; HPV; age at vaccination; cancer; cervical cancer screening; prevention; prophylactic vaccination.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Percentage of vaccinated women according to year of birth, stratified by age at vaccination.
Figure 2
Figure 2
Forest plot of the relative risks of CIN2+ (a) and CIN3+ (b) in vaccinated vs. unvaccinated women, according to age at vaccination, with 95% confidence intervals. Note: RR: Relative Risk; 95% CI: 95% Confidence Interval; NaN: Not a number.
Figure 3
Figure 3
Flowchart of the study for women invited to cytology-based screening (A) or to HPV-based screening (B).
See this image and copyright information in PMC

References

    1. Gravitt P.E., Winer R.L. Natural history of HPV infection across the lifespan: Role of latency. Viruses. 2017;9:267. doi: 10.3390/v9100267. - DOI - PMC - PubMed
    1. Serraino D., Gini A., Taborelli M., Ronco G., Giorgi-Rossi P., Zappa M., Crocetti E., Franzo E., Falcini F., Visioli C.B., et al. Changes in cervical cancer incidence followiong the introduction of organized screening in Italy. Prev. Med. 2015;75:56–63. doi: 10.1016/j.ypmed.2015.01.034. - DOI - PubMed
    1. Ronco G., Dillner J., Elfström K.M., Tunesi S., Snijders P.J., Arbyn M., Kitchener H., Segnan N., Gilham C., Giorgi-Rossi P., et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: Follow-up of four European randomised controlled trials. Lancet. 2014;383:524–532. doi: 10.1016/S0140-6736(13)62218-7. - DOI - PubMed
    1. Castle P.E., Maza M. Prophylactic HPV vaccination: Past, present, and future. Epidemiol. Infect. 2016;144:449–468. doi: 10.1017/S0950268815002198. - DOI - PubMed
    1. Herwijer E., Sundstrom K., Ploner A., Uhnoo I., Sparen P., Arnheim-Dahlstrom L. Quadrivalent HPV vaccine effectiveness against high-grade cervical lesions by age at vaccination: A population-based study. Int. J. Cancer. 2016;138:2867–2874. doi: 10.1002/ijc.30035. - DOI - PMC - PubMed

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