Assessing Impact of HPV Vaccination on Cervical Cancer Incidence among Women Aged 15-29 Years in the United States, 1999-2017: An Ecologic Study.
Assessing Impact of HPV Vaccination on Cervical Cancer Incidence among Women Aged 15-29 Years in the United States, 1999-2017: An Ecologic Study.
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评估 1999-2017 年 HPV 疫苗接种对美国 15-29 岁女性宫颈癌发病率的影响：一项生态学研究。
DOI：
10.1158/1055-9965.epi-20-0846
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发表时间：
2021-01
期刊：
影响因子：
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通讯作者：
Thomas CC
中科院分区：
文献类型：
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作者：
Mix JM;Van Dyne EA;Saraiya M;Hallowell BD;Thomas CC
到目前为止，人类乳头瘤病毒(HPV)疫苗对美国浸润性宫颈癌的影响尚未被记录在案，部分原因是癌症的发展需要时间，以及最近宫颈癌筛查指南和建议的变化使数据解释复杂化。我们使用覆盖97.8%美国人口的基于人群的癌症登记数据，检查了1999-2017年间确诊的15-29岁女性中宫颈鳞状细胞癌(SCC)和腺癌(AC)的发病率。趋势是按年龄和组织学分层的。使用Joinpoint回归计算每年宫颈癌发病率的年变化百分比。1999-2017年间，15-20岁女性的鳞癌发病率每年下降7.9%，21-24岁女性下降5.5%，25-29岁女性下降2.3%。从2011年到2017年，15-20岁女性的鳞癌发病率降幅最大，每年下降22.5%。总体而言，15-20岁妇女的AC率每年下降4.1%，21-24岁妇女每年下降3.6%，25-29岁妇女每年下降1.6%。从2005年到2017年，15-20岁女性的AC发病率下降最多，每年下降11.2%。自从引入HPV疫苗以来，15-20岁女性的鳞癌和AC发病率都有所下降，这一群体通常没有进行宫颈癌筛查，这可能表明HPV疫苗的影响。及时接种疫苗，改进推荐年龄段的筛查和随访，可能会进一步减少浸润性宫颈癌的发生。
To date, the impact of the human papillomavirus (HPV) vaccine on invasive cervical cancers in the United States has not been documented due, in part, to the time needed for cancer to develop, and to recent changes to cervical cancer screening guidelines and recommendations which complicate data interpretation. We examined incidence rates of cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) among women aged 15–29 years diagnosed during 1999–2017 using population-based cancer registry data covering 97.8% of the US population. Trends were stratified by age and histology. The annual percent change in cervical cancer incidence per year was calculated using Joinpoint regression. During 1999–2017, SCC rates decreased 7.9% per year among women aged 15–20 years, 5.5% among women aged 21–24 years, and 2.3% among women aged 25–29 years. The declines in SCC rates were largest among women aged 15–20 years from 2011 to 2017, with a decrease of 22.5% per year. Overall, AC rates decreased 4.1% per year among women aged 15–20 years, 3.6% per year among women aged 21–24 years, and 1.6% per year among women 25–29 years. AC rates declined the most among women aged 15–20 years during 2005 to 2017, decreasing 11.2% per year. Since HPV vaccine introduction, both SCC and AC incidence rates declined among women aged 15–20 years, a group not typically screened for cervical cancer, which may suggest HPV vaccine impact. Timely vaccination and improved screening and follow-up among recommended age groups could result in further reductions in invasive cervical cancer.