Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Pediatrics - Hematology/Oncology, Emory University School of Medicine; The Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
J Cancer Surviv. 2019 Oct;13(5):730-738. doi: 10.1007/s11764-019-00791-9. Epub 2019 Jul 24.
To estimate the population-based incidence of HPV vaccination after childhood cancer.
Pediatric and young adult cancer survivors identified in the institutional Comprehensive Cancer Center registry were linked to the North Carolina Immunization Registry (NCIR). Initiation and completion of any HPV vaccine was evaluated in survivors born between 1984 and 2002 with an NCIR record by December 2014. Descriptive statistics and Kaplan-Meier estimates of cumulative incidence were stratified by sex and age at eligibility for vaccine. Cox proportional hazards were conducted and stratified by sex.
Among 879 (n = 428 female; n = 451 male) study-eligible cancer survivors without prior HPV vaccination (n = 501 < 18 years, n = 378 ≥ 18 years at the time of eligibility), the cumulative incidence of HPV vaccine initiation following cancer therapy was 48.1% among females at 8.2 years and 29.2% among males at 5.0 years after vaccine eligibility among those < 18 years, and 6.2% among females at 8.1 years and 2.0% among males at 4.2 years after vaccine eligibility among those ≥ 18 years. Among those who initiated vaccination, 53% of females and 43% of males completed a 3-dose series. Younger age at cancer diagnosis (≤ 10 and 11-14 years vs. ≥ 15 years) and shorter interval from diagnosis to vaccine eligibility were more likely to initiate vaccination in models adjusted for age at eligibility, race/ethnicity, cancer type, relapse, and transplant.
Despite the benefit of a cancer prevention strategy, cancer survivors are sub-optimally vaccinated against HPV.
Immunization registries can help oncologists and primary care providers identify gaps in vaccination and target HPV vaccine delivery in survivors.
评估儿童癌症后 HPV 疫苗接种的人群发病率。
在机构综合癌症中心登记处确定的儿科和青年癌症幸存者与北卡罗来纳免疫登记处（NCIR）相关联。对 1984 年至 2002 年间出生且在 2014 年 12 月前有 NCIR 记录的幸存者进行任何 HPV 疫苗接种的起始和完成情况评估。按性别和疫苗接种资格年龄分层，对女性和男性的累积发病率进行描述性统计和 Kaplan-Meier 估计。按性别分层进行 Cox 比例风险分析。
在 879 名（n=428 名女性；n=451 名男性）无 HPV 疫苗接种史的研究合格癌症幸存者中（n=501 名<18 岁，n=378 名在符合疫苗接种资格时≥18 岁），在符合疫苗接种资格后 8.2 岁时，女性 HPV 疫苗接种起始累积率为 48.1%，男性为 5.0 岁时为 29.2%，<18 岁者；在符合疫苗接种资格后 8.1 岁时，女性为 6.2%，男性为 4.2 岁时为 2.0%，≥18 岁者。在接种疫苗的人群中，53%的女性和 43%的男性完成了 3 剂系列接种。在调整了疫苗接种资格年龄、种族/民族、癌症类型、复发和移植的模型中，癌症诊断年龄更小（≤10 岁和 11-14 岁 vs. ≥15 岁）和从诊断到疫苗接种资格的间隔时间更短，更有可能开始接种疫苗。
尽管癌症预防策略有好处，但癌症幸存者接种 HPV 疫苗的情况并不理想。
免疫登记处可以帮助肿瘤学家和初级保健提供者发现疫苗接种方面的差距，并针对幸存者提供 HPV 疫苗接种。
