The Kirby Institute, University of New South Wales, Sydney, NSW
The Kirby Institute, University of New South Wales, Sydney, NSW.
Med J Aust. 2017 Mar 20;206(5):204-209. doi: 10.5694/mja16.00597.
To examine the impact of the national human papillomavirus (HPV) vaccination program (available to girls and women [12-26 years] since 2007 and to boys [12-15 years] since 2013) on the number of diagnoses of genital warts in Australian Aboriginal and Torres Strait Islander (Indigenous) people.
DESIGN, SETTING, PARTICIPANTS: Analysis of routinely collected data from patients attending 39 sexual health clinics (SHCs) in the Genital Warts Surveillance Network for the first time.Major outcome: The average annual proportion of Indigenous and non-Indigenous SHC patients diagnosed with genital warts during the pre-vaccination (2004-2007) and vaccination periods (2008-2014), stratified by age group and sex.
7.3% of the 215 599 Australian-born patients with known Indigenous status and seen for the first time at participating SHCs during 2004-2014 were Indigenous Australians. The average proportion of female Indigenous patients diagnosed with warts was lower during the vaccination period than during the pre-vaccination period (in those under 21, summary rate ratio [SRR], 0.12; 95% CI, 0.07-0.21; P < 0.001); in 21-30-year olds: SRR, 0.41; 95% CI, 0.27-0.61; P < 0.001); there was no significant difference for women over 30 (SRR, 0.84; 95% CI, 0.51-1.36; P = 0.47). The proportion of male Indigenous heterosexual SHC patients under 21 diagnosed with warts was also lower during the vaccination period (SRR, 0.25; 95% CI, 0.12-0.49; P < 0.001), with no significant changes among older Indigenous men over 30.
There were marked declines in the proportions of diagnoses of genital warts in young Indigenous women and men attending SHCs after the introduction of the HPV vaccination program. If high levels of HPV vaccine coverage are sustained, HPV-related cancer rates should also decline.
研究国家人乳头瘤病毒（HPV）疫苗接种计划（2007 年起可为女孩和妇女[12-26 岁]，2013 年起可为男孩[12-15 岁]接种）对澳大利亚原住民和托雷斯海峡岛民（土著）人中生殖器疣诊断数量的影响。
设计、地点和参与者：对首次参加生殖器疣监测网络的 39 个性健康诊所（SHC）的患者进行常规收集数据的分析。主要结果：按年龄组和性别分层，在疫苗接种前（2004-2007 年）和疫苗接种期间（2008-2014 年），每例初次就诊于参与性健康诊所的澳大利亚出生的已知土著身份的 215599 例患者中，土著澳大利亚人被诊断患有生殖器疣的比例。在疫苗接种期间，女性土著患者被诊断患有疣的比例低于疫苗接种前（21 岁以下患者：汇总率比[SRR]，0.12；95%CI，0.07-0.21；P<0.001）；21-30 岁患者：SRR，0.41；95%CI，0.27-0.61；P<0.001）；30 岁以上女性无显著差异（SRR，0.84；95%CI，0.51-1.36；P=0.47）。21 岁以下的男性土著异性恋 SHC 患者被诊断患有疣的比例也在疫苗接种期间降低（SRR，0.25；95%CI，0.12-0.49；P<0.001），而 30 岁以上的土著男性则没有显著变化。
在 HPV 疫苗接种计划推出后，年轻的土著妇女和男性在 SHC 就诊时生殖器疣的诊断比例明显下降。如果 HPV 疫苗的高覆盖率得以维持，HPV 相关癌症的发病率也应该会下降。
