Beneficial Effects of Human Papillomavirus Vaccine for Prevention of Cervical Abnormalities in Miyagi, Japan
Beneficial Effects of Human Papillomavirus Vaccine for Prevention of Cervical Abnormalities in Miyagi, Japan
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DOI：
10.1620/tjem.240.147
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发表时间：
2016-10-01
影响因子：
2.2
通讯作者：
Yaegashi, Nobuo
中科院分区：
文献类型：
--
作者：
Ozawa, Nobuyoshi;Ito, Kiyoshi;Yaegashi, Nobuo
在日本，由于癌症筛查和疫苗接种率较低，宫颈癌的预防一直不成功。日本政府疫苗不良反应审查委员会调查了2475起不良事件，报告了617例(6.9/100,000)重症病例和176(2.0/100,000)例慢性疼痛。自2013年6月以来，主动推荐接种人乳头状瘤病毒(HPV)疫苗的做法已暂停。在这项研究中，我们调查了参加宫城癌症筛查的20至24岁妇女的疫苗接种率和宫颈细胞学异常的发生率。在2014财年(2014年4月至2015年3月)接受健康检查的3272名妇女中，有332人(10.2%)接种了HPV疫苗。20、21、22、23、24岁女性HPV接种率分别为42.3%、10%、17.5%、3.8%和4.0%。接种过HPV疫苗的妇女非典型鳞状细胞(ASC-US)发生率为2.41%(8/332)，未接种HPV妇女为5.03%(148/2,940)，差异有统计学意义(P=0.03)。对ASC-US病例进行HPV DNA检测。此外，接种HPV疫苗的妇女高度鳞状上皮内病变(HSIL)或更严重的发生率为0.30%(1/332)，未接种HPV的妇女为0.82%(24/2,940)，接种HPV疫苗的妇女HSIL发生率略有下降(P=0.3)。因此，这项研究表明，接种HPV疫苗与降低宫颈异常的发生率有关，这表明有必要进行科学讨论，恢复日本对HPV疫苗的积极推荐。
Prevention of cervical cancer has been unsuccessful in Japan because of low rates of cancer screening and vaccination. The Vaccine Adverse Review Committee of the Japanese Government investigated 2,475 adverse events and reported 617 (6.9/100,000) severe cases and 176 (2.0/100,000) cases with chronic pain. The proactive recommendation for human papillomavirus (HPV) vaccination has been suspended since June 2013. In this study, we examined vaccination rate and incidence of abnormal cervical cytology in women aged 20 to 24 years attending cancer screening in Miyagi. Among the 3,272 women who underwent a health check in the fiscal year 2014 (April 2014-March 2015), 332 (10.2%) received a HPV vaccination. The HPV vaccination rates were 42.3%, 10%, 17.5%, 3.8% and 4.0% in women aged 20, 21, 22, 23 and 24 years, respectively. The rates of atypical squamous cells of undetermined significance (ASC-US) or worse were 2.41% (8/332) in women with HPV vaccination and 5.03% (148/2,940) in those without HPV vaccination, indicating a significant decrease in vaccinated women (p = 0.03). ASC-US cases were referred to HPV DNA tests. In addition, the rates of high grade squamous intraepithelial lesion (HSIL) or worse were 0.30% (1/332) in women with HPV vaccination and 0.82% (24/2,940) in those without HPV vaccination, showing the marginal decrease in women who were vaccinated (p = 0.3). Thus, this study indicates that HPV vaccination is associated with a reduction in the incidence of cervical abnormalities, suggesting a need for scientific discussion of reinstatement of proactive recommendation for HPV vaccine in Japan.