Hansen Bo T, Campbell Suzanne, Nygård Mari
Department of Research, Cancer Registry of Norway, Oslo, Norway.
BMJ Open. 2018 Feb 23;8(2):e019005. doi: 10.1136/bmjopen-2017-019005.
Examine long-term incidence trends of human papillomavirus (HPV)-related cancer in Norway, and estimate the number of cancer cases preventable by vaccines against HPV 16/18 or HPV 16/18/31/33/45/52/58.
Observational registry-based study. We extracted incident cases of HPV-related cancer during 1953-2015 from the Cancer Registry of Norway. Tumour HPV prevalence estimates from large international meta-analyses or from Norway were used to estimate the protective potential of HPV vaccines.
The Norwegian population.
Incidence trend analyses during 1953-2015 for squamous cell carcinoma (SCC) of the cervix, vulva, vagina, oropharynx, anus and penis, and adenocarcinoma of the cervix. Additionally, the number of cancer cases preventable by HPV vaccination.
Among women, incidences of SCC of the anus, oropharynx, vulva and cervical adenocarcinoma increased, while vaginal SCC showed no trend. For these cancers combined, the average annual percentage change (AAPC) during 1953-2015 was 1.2 (95% CI 0.7 to 1.6). The incidence of cervical SCC generally decreased during 1976-2004 and remained stable thereafter. Among men, incidences of SCC of the anus, oropharynx and penis increased. The AAPC during 1953-2015 combined for all male HPV-related cancer was 1.9 (95% CI 1.3 to 2.5). A vaccine against HPV 16/18 might yearly prevent 402 (95% CI 382 to 420) cancers. A vaccine against HPV 16/18/31/33/45/52/58 might yearly prevent 478 (95% CI 464 to 490) cancers, of which 206 (95% CI 202 to 209) occur in non-cervical organs, and 113 (95% CI 110 to 115) occur among men.
The incidences of HPV-related cancers that are not effectively prevented by screening have generally increased during 1953-2015. HPV vaccination can prevent a substantial number of cancers in Norway, in cervical and non-cervical organs, among women and men.
研究挪威人乳头瘤病毒（HPV）相关癌症的长期发病趋势，并估算可通过接种针对HPV 16/18或HPV 16/18/31/33/45/52/58的疫苗预防的癌症病例数。
基于观察性登记的研究。我们从挪威癌症登记处提取了1953 - 2015年期间HPV相关癌症的发病病例。使用来自大型国际荟萃分析或挪威的肿瘤HPV流行率估计值来评估HPV疫苗的保护潜力。
挪威人口。
1953 - 2015年期间子宫颈、外阴、阴道、口咽、肛门和阴茎鳞状细胞癌（SCC）以及子宫颈腺癌的发病趋势分析。此外，估算可通过HPV疫苗预防的癌症病例数。
在女性中，肛门、口咽、外阴SCC以及子宫颈腺癌的发病率上升，而阴道SCC无明显趋势。这些癌症综合起来，1953 - 2015年期间的年均变化百分比（AAPC）为1.2（95%可信区间0.7至1.6）。子宫颈SCC的发病率在1976 - 2004年期间总体下降，此后保持稳定。在男性中，肛门、口咽和阴茎SCC的发病率上升。1953 - 2015年期间所有男性HPV相关癌症综合起来的AAPC为1.9（95%可信区间1.3至2.5）。针对HPV 16/18的疫苗每年可能预防402例（95%可信区间382至420）癌症。针对HPV 16/18/31/33/45/52/58的疫苗每年可能预防478例（95%可信区间464至490）癌症，其中206例（95%可信区间202至209）发生在非子宫颈器官，113例（95%可信区间110至115）发生在男性中。
在1953 - 2015年期间，筛查无法有效预防的HPV相关癌症的发病率总体呈上升趋势。HPV疫苗接种可在挪威预防大量女性和男性子宫颈及非子宫颈器官的癌症。
