A nationwide birth year-by-year analysis of effectiveness of HPV vaccine in Japan.
A nationwide birth year-by-year analysis of effectiveness of HPV vaccine in Japan.
复制标题
DOI：
10.1111/cas.15060
复制
发表时间：
2021-09
期刊：
影响因子：
5.7
通讯作者：
Kimura T
中科院分区：
文献类型：
--
作者：
Yagi A;Ueda Y;Nakagawa S;Masuda T;Miyatake T;Ikeda S;Abe H;Hirai K;Sekine M;Miyagi E;Enomoto T;Nakayama T;Kimura T
在日本，年轻女性中按年龄调整的宫颈癌发病率持续快速增长。我们着手准确确认日本 HPV 疫苗的有效性。数据收集对象为 1990 至 1997 财年 (FY) 出生的女性，这些女性在 2010 至 2017 财年期间有资格进行 20 岁宫颈癌筛查。1990 至 1993 财年出生的女性（即在引入公共补贴 HPV 疫苗接种之前达到国家疫苗接种目标年龄的女性）宫颈上皮内瘤变 (CIN)1+ 的调整后发病率，参考下文称为“引进前一代”，为 1.42% (242/17 040)。 “疫苗一代”（1994年至1997财年出生的女性，即在国家目标年龄13-16岁期间大量接种疫苗的群体）的发病率为1.66%（135/8020）。这些发病率之间没有显着差异。然而，我们的逐年出生分析显示，CIN1+ 的发生率明显低于仅根据引入前一代 CIN1+ 趋势预测的结果。我们的分析显示，接种疫苗一代的 CIN3+ 发病率明显低于引入前一代 (P = .0008)。在引入前和接种疫苗的世代中，CIN 的发病率已经呈上升趋势。必须检查每个生育年度的 CIN 发病率变化，以准确确定 HPV 疫苗对减少轻度宫颈病变的实际效果。这是日本首次显示HPV疫苗对CIN3+具有显着预防效果的大规模研究。 CIN1+ 的发生率在疫苗接种一代和引入前一代中是相同的。由于CIN 1+的发病率在两代人中均呈上升趋势，因此必须检查每个生育年度的CIN 1+发病率的变化，以准确确定HPV疫苗减少轻度宫颈病变的实际效果。
In Japan, the age‐adjusted incidence of cervical cancer has been increasing constantly and rapidly among younger women. We set out to accurately confirm the effectiveness of the HPV vaccine in Japan. Data were collected for women born in the fiscal year (FY) 1990 to 1997, who became eligible for their 20‐y‐old cervical cancer screening between the FY 2010 to 2017. The adjusted incidence of cervical intraepithelial neoplasia (CIN)1+ in women born in FY 1990 to 1993, that is those who reached the national vaccination target age prior to the introduction of publicly subsidized HPV vaccinations, referred here after as “the pre‐introduction generation”, was 1.42% (242/17 040). The incidence in the “vaccination generation” (women born in FY 1994 to 1997, that is those who were heavily vaccinated as a group when they were of the nationally targeted age of 13‐16) was 1.66% (135/8020). There was no significant difference between these incidence rates. However, our FY birth year‐by‐year analysis revealed that the incidence of CIN1+ was obviously lower than that predicted based on just the trend for CIN1+ seen in the pre‐introduction generation. Our analysis revealed that the incidence of CIN3+ was obviously lower in the vaccination generation than in the pre‐introduction generation (P = .0008). The incidence of CIN was already tending to increase in both the pre‐introduction and vaccination generations. The changes in CIN incidence by individual birth FY must be examined to accurately determine the actual effects of the HPV vaccine for reducing mild cervical lesions. This is the first large‐scale study in Japan to show a significant preventive effect of HPV vaccine against CIN3+. The incidence of CIN1+ was the same in both the vaccination and the pre‐introduction generation. Because the incidence of CIN 1+ was tending to increase in both generations, the changes in CIN 1+ incidence by individual birth FY must be examined to accurately determine the actual effects of HPV vaccine for reducing mild cervical lesions.
登录
查看更多内容
影响因子：
5.7
作者：
Nakagawa, Satoshi;Ueda, Yutaka;Kimura, Tadashi
通讯作者：
Kimura, Tadashi
影响因子：
6.4
作者：
Muñoz, N;Bosch, FX;Meijer, CJLM
通讯作者：
Meijer, CJLM
影响因子：
6.4
作者：
Kudo, Risa;Yamaguchi, Manako;Enomoto, Takayuki
通讯作者：
Enomoto, Takayuki
影响因子：
5.7
作者：
Ikeda S;Ueda Y;Hara M;Yagi A;Kitamura T;Kitamura Y;Konishi H;Kakizoe T;Sekine M;Enomoto T;Sobue T
通讯作者：
Sobue T
影响因子：
158.5
作者：
Lei, Jiayao;Ploner, Alexander;Sparen, Par
通讯作者：
Sparen, Par