Ogilvie Gina S, Naus Monika, Money Deborah M, Dobson Simon R, Miller Dianne, Krajden Mel, van Niekerk Dirk J, Coldman Andrew J
Faculty of Medicine, University of British Columbia, Woodward Instructional Resource Centre, Vancouver, BC, Canada.
British Columbia Centre for Disease Control, Vancouver, BC, Canada.
Int J Cancer. 2015 Oct 15;137(8):1931-7. doi: 10.1002/ijc.29508. Epub 2015 Jun 3.
We report on the rates of cervical intraepithelial neoplasia (CIN) in young women aged 15-22 years of age in British Columbia before and after the introduction of an HPV vaccine program. Rates of cervical intraepithelial neoplasia (CIN) 2+ for each age stratum (15-22) in the calendar years 2004-2012 for the province of British Columbia were obtained from the BC Cancer Agency's population-based cervical cancer program. Incidence rate ratios (IRR) of CIN2+ were described and compared before and after HPV vaccine program introduction in cohorts born in vaccine eligible years, and in non-vaccine eligible years using piece-wise Poisson regression analysis, and adjusted for age. Between 2004 and 2012, rates of CIN2 and CIN2+ in young women aged 15-22 years in the province of British Columbia have decreased overall. After the introduction of the HPV vaccine program, the age adjusted IRR for CIN2+ for young women aged 15-17 years decreased significantly from 0.91 (95% CI: 0.86-0.98 p < 0.01) to 0.36 (95% CI: 0.18-0.73 p < 0.01). During the same time period, no similar reduction was found in young women 18-22 years. After introduction of HPV vaccine program, IRR for CIN2+ in young women 15-17 was significantly reduced for CIN2+ (0.14; 95% CI: 0.04- 0.47; p < 0.01) and CIN2 (0.1; 95% CI: 0.02-0.54; p < 0.01). This ecological analysis shows a significant reduction in CIN2+ lesions in young women aged 15-17 years in British Columbia after the introduction of the HPV vaccine in young women despite vaccine uptake levels below 70%.
我们报告了在不列颠哥伦比亚省引入HPV疫苗计划前后，15至22岁年轻女性的宫颈上皮内瘤变（CIN）发生率。2004年至2012年期间，不列颠哥伦比亚省各年龄层（15至22岁）的CIN 2+发生率数据来自不列颠哥伦比亚癌症机构基于人群的宫颈癌项目。使用分段泊松回归分析描述并比较了在符合疫苗接种条件年份出生的队列以及不符合疫苗接种条件年份出生的队列中，引入HPV疫苗计划前后CIN2+的发病率比（IRR），并对年龄进行了调整。2004年至2012年期间，不列颠哥伦比亚省15至22岁年轻女性的CIN2和CIN2+发生率总体呈下降趋势。引入HPV疫苗计划后，15至17岁年轻女性CIN2+的年龄调整后IRR从0.91（95%CI：0.86 - 0.98，p＜0.01）显著降至0.36（95%CI：0.18 - 0.73，p＜0.01）。在同一时期，18至22岁的年轻女性未发现类似的下降情况。引入HPV疫苗计划后，15至17岁年轻女性CIN2+的IRR在CIN2+（0.14；95%CI：0.04 - 0.47；p＜0.01）和CIN2（0.1；95%CI：0.02 - 0.54；p＜0.01）方面显著降低。这项生态学分析表明，尽管疫苗接种率低于70%，但在不列颠哥伦比亚省年轻女性中引入HPV疫苗后，15至17岁年轻女性的CIN2+病变显著减少。
