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Cervical Intraepithelial Neoplasia Rates in British Columbia Women: A Population-Level Data Linkage Evaluation of the School-Based HPV Immunization Program.
The Journal of Infectious Diseases ( IF 6.4 ) Pub Date : 2020-01-01 , DOI: 10.1093/infdis/jiz422
C Sarai Racey 1, 2 , Arianne Albert 2 , Robine Donken 1, 2, 3 , Laurie Smith 2, 4 , John J Spinelli 1, 4 , Heather Pedersen 1, 2 , Pamela de Bruin 5 , Cindy Masaro 6 , Sheona Mitchell-Foster 1, 7 , Manish Sadarangani 1, 6 , Meena Dawar 1, 6 , Mel Krajden 1, 8 , Monika Naus 1, 8 , Dirk van Niekerk 1, 4 , Gina Ogilvie 1, 2
Affiliation  

BACKGROUND To understand real-world human papillomavirus (HPV) vaccine impact, continuous evaluation using population-based data is critical. We evaluated the early impact of the school-based HPV immunization program on cervical dysplasia in women in British Columbia, Canada. METHODS Data linkage was performed using records from provincial cervical screening and immunization registries. Precancerous outcomes were compared between unvaccinated and HPV-vaccinated women born 1994-2005. Incidence rate, relative rate (RR), and vaccine effectiveness (VE), using unadjusted and adjusted Poisson regression of cytology (HSIL) and histopathology (CIN2, CIN3, and CIN2+) outcomes, were compared across vaccination status groups. RESULTS Women who received a complete series of vaccine on schedule between age 9 and 14 years had an adjusted RR = 0.42 (95% confidence interval [CI], 0.31-0.57) for CIN2+ over 7 years of follow-up compared to unvaccinated women, resulting in a VE of 57.9% (95% CI, 43.2%-69.0%). Adjusted RR for HSIL was 0.53 (95% CI, .43-.64), resulting in a VE of 47.1% (95% CI, 35.6%-56.7%). CONCLUSION Women vaccinated against HPV have a lower incidence of cervical dysplasia compared to unvaccinated women. Immunization between 9 and 14 years of age should be encouraged. Continued program evaluation is important for measuring long-term population impact.

中文翻译:

不列颠哥伦比亚省妇女的宫颈上皮内瘤形成率:基于学校的HPV免疫计划的人口水平数据关联评估。

背景技术为了了解现实世界中的人乳头瘤病毒(HPV)疫苗的影响,使用基于人群的数据进行连续评估至关重要。我们评估了加拿大不列颠哥伦比亚省基于学校的HPV免疫计划对宫颈发育异常的早期影响。方法采用省级子宫颈普查和免疫登记处的记录进行数据链接。比较了1994年至2005年出生的未接种疫苗和HPV疫苗接种妇女的癌前结果。使用未调整和调整的细胞学泊松回归(HSIL)和组织病理学(CIN2,CIN3和CIN2 +)结果的发生率,相对率(RR)和疫苗有效性(VE),在疫苗接种状态组之间进行了比较。结果计划在9至14岁之间接受完整疫苗接种的妇女的调整后RR = 0。与未接种疫苗的女性相比,在7年的随访中,CIN2 +为42(95%置信区间[CI],0.31-0.57),因此VE为57.9%(95%CI,43.2%-69.0%)。HSIL的调整后RR为0.53(95%CI,.43-.64),VE为47.1%(95%CI,35.6%-56.7%)。结论接受HPV疫苗接种的妇女与未接种疫苗的妇女相比,宫颈发育异常的发生率较低。应鼓励在9至14岁之间进行免疫接种。持续进行方案评估对于衡量长期人口影响非常重要。结论接受HPV疫苗接种的妇女与未接种疫苗的妇女相比,宫颈发育异常的发生率较低。应鼓励在9至14岁之间进行免疫接种。持续进行方案评估对于衡量长期人口影响非常重要。结论接受HPV疫苗接种的妇女与未接种疫苗的妇女相比,宫颈发育异常的发生率较低。应鼓励在9至14岁之间进行免疫接种。持续进行方案评估对于衡量长期人口影响非常重要。
更新日期:2019-08-23
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