Human papillomavirus vaccine effectiveness within a cervical cancer screening programme: cohort study
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2021-02-01
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BJOG: An International Journal of Obstetrics and Gynaecology
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WILEY
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Melbourne School of Population and Global Health
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Journal Article
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Acuti Martellucci, C., Nomura, S., Yoneoka, D., Ueda, P., Brotherton, J. M. L., Canfell, K., Palmer, M., Manzoli, L., Giorgi Rossi, P., De Togni, A., Palmonari, C., Califano, A., Saito, E., Hashizume, M. & Shibuya, K. (2021). Human papillomavirus vaccine effectiveness within a cervical cancer screening programme: cohort study. BJOG an International Journal of Obstetrics and Gynaecology, 128 (3), pp.532-539. https://doi.org/10.1111/1471-0528.16429.
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Abstract
OBJECTIVE: To assess the effectiveness of an HPV vaccination programme in reducing the risk of cervical abnormalities identified at subsequent screening. DESIGN: Retrospective cohort study using administrative health data. SETTING: General population of Ferrara Province, Italy. POPULATION: Female residents born in 1986-1993 and participating in the organized cervical screening programme in 2011-2018, who were eligible for HPV vaccination in catch-up cohorts. METHODS: Logistic regression to evaluate the potential association between abnormal cervical cytology and one, two, three or at least one dose of HPV vaccine. MAIN OUTCOME MEASURES: Cervical abnormalities, as predicted by low-grade or high-grade cytology, by number of vaccine doses, stratified by age. RESULTS: The sample consisted of 7785 women (mean age 27.5 years, SD 2.3). Overall, 391 (5.0%) were vaccinated with ≥1 dose and 893 (11.5%) had abnormal cytology. Women receiving at least one vaccine dose were significantly less likely to have an abnormal cytology (adjusted odds ratio 0.52; 95% confidence interval 0.34-0.79). Similar results were observed for women receiving a single dose, for both bivalent and quadrivalent vaccines, and applying buffer periods (excluding cytological outcomes within 1 month, 6 months and 1 year of the first dose). CONCLUSIONS: In the context of an organised cervical screening programme in Italy, catch-up HPV vaccination almost halved the risk of cytological abnormalities. TWEETABLE ABSTRACT: Among Ferrara women, vaccination against human papillomavirus halved the risk of screening cervical abnormalities.