Investigating the impact of Britain's HPV vaccination program to inform national public health interventions in the next decade

调查英国 HPV 疫苗接种计划的影响，为未来十年的国家公共卫生干预措施提供信息

• 批准号: 2549342
• 金额: --
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2549342
• 关键词: Investigating; impact; Britain; HPV; vaccination

Most cervical cancer cases are caused by infection with high-risk human papillomavirus (HPV), particularly HPV types 16 and 18. Annually, there are approximately 3,200 new cases of cervical cancer in the UK. However, HPV-related cancers, such as cervical cancer, can be prevented through vaccination. Cervical cancer can also be prevented through early detection and treatment of abnormal cells through routine cervical cancer screening (offered to all women aged 25 and over). In the UK, the HPV vaccine (bivalent Cervarix until September 2012, quadrivalent Gardasil from 2012-2021, and 9-valent Gardasil 9 in 2021/2022) has been offered to all girls aged 12 or 13 years since 2008. The program was expanded to include boys in the same age bracket in July 2018, as well as men who have sex with men (MSM) in April 2018. Early evidence, both in the UK and globally, suggests that the vaccination program has been highly successful at reducing HPV prevalence among vaccinated individuals and therefore preventing HPV-related cancers, though it is unclear whether the effects and uptake are consistent across population groups. It is also unclear whether 'type replacement' of the vaccine-preventable HPV types (e.g. high-risk HPV types 16/18) with non-vaccine types, or cross-protection of non-vaccine types, will occur. The decennial National Survey of Sexual Attitudes and Lifestyles (Natsal) study is a representative population survey on sexual health in Britain. Natsal-2 (1999-2001) provided baseline type-specific HPV prevalence used to inform the design of the vaccination program, and the most recent Natsal study (Natsal-3; 2010-12) captured the early effects of the initial catch-up HPV vaccination program and inequalities in cervical cancer screening uptake. Data from Natsal-4 (2022-23) will be crucial to determine the effect of these HPV interventions at a population level. This project will use data from the Natsal-4 study, as well as routine surveillance data, to analyse type-specific HPV prevalence and uptake of HPV vaccination and cervical cancer screening uniquely linked to a range of demographic and behavioural factors to assess impact on inequalities and opportunities for targeted interventions. Over the next ten years, these data will be critical to inform national public health policy and mathematical models estimating a range of interventions, including adaptations to vaccine schedule (e.g. to single dose), cervical cancer screening, and roll out to younger age groups.

大多数宫颈癌病例是由高危型人乳头瘤病毒（HPV）感染引起的，特别是HPV 16和18型。每年，英国大约有3,200例宫颈癌新发病例。然而，HPV相关的癌症，如宫颈癌，可以通过接种疫苗来预防。还可以通过常规宫颈癌筛查（向所有25岁及以上妇女提供）及早发现和治疗异常细胞来预防宫颈癌。在英国，HPV疫苗（二价Cervarix至2012年9月，四价Gardasil从2012年至2021年，9价Gardasil 9在2021/2022年）自2008年以来已提供给所有12或13岁的女孩。该计划于2018年7月扩大到包括同一年龄段的男孩，以及2018年4月的男男性行为者（MSM）。英国和全球的早期证据表明，疫苗接种计划在降低接种个体的HPV患病率方面非常成功，因此预防了HPV相关癌症，尽管目前尚不清楚这些影响和摄取在人群中是否一致。目前还不清楚是否会发生疫苗可预防的HPV类型（例如高危HPV 16/18型）与非疫苗类型的“类型替换”或非疫苗类型的交叉保护。十年一度的全国性态度和生活方式调查（Natsal）研究是英国性健康的代表性人口调查。Natsal-2（1999-2001）提供了用于为疫苗接种计划的设计提供信息的基线类型特异性HPV患病率，最近的Natsal研究（Natsal-3; 2010-12）捕获了初始追赶HPV疫苗接种计划的早期影响和宫颈癌筛查摄取的不平等。来自Natsal-4（2022-23）的数据对于确定这些HPV干预措施在人群水平上的效果至关重要。该项目将使用Natsal-4研究的数据以及常规监测数据，分析特定类型的HPV流行率和HPV疫苗接种率以及与一系列人口和行为因素独特相关的宫颈癌筛查，以评估对不平等的影响和有针对性的干预机会。在未来十年，这些数据将为国家公共卫生政策和数学模型提供重要信息，以估计一系列干预措施，包括调整疫苗接种时间表（例如单剂量），宫颈癌筛查以及向年轻群体推广。