Centers for Disease Control and Prevention, Atlanta, Georgia.
Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee.
Cancer Epidemiol Biomarkers Prev. 2021 Jan;30(1):30-37. doi: 10.1158/1055-9965.EPI-20-0846. Epub 2020 Oct 20.
To date, the impact of the human papillomavirus (HPV) vaccine on invasive cervical cancers in the United States has not been documented due, in part, to the time needed for cancer to develop and to recent changes to cervical cancer screening guidelines and recommendations, which complicate data interpretation.
We examined incidence rates of cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) among women aged 15-29 years diagnosed during 1999-2017 using population-based cancer registry data covering 97.8% of the U.S.
Trends were stratified by age and histology. The annual percent change in cervical cancer incidence per year was calculated using joinpoint regression.
During 1999-2017, SCC rates decreased 12.7% per year among women aged 15-20 years, 5.5% among women aged 21-24 years, and 2.3% among women aged 25-29 years. The declines in SCC rates were largest among women aged 15-20 years during 2010-2017, with a decrease of 22.5% per year. Overall, AC rates decreased 4.1% per year among women aged 15-20 years, 3.6% per year among women aged 21-24 years, and 1.6% per year among women aged 25-29 years. AC rates declined the most among women aged 15-20 years during 2006-2017, decreasing 9.4% per year.
Since HPV vaccine introduction, both SCC and AC incidence rates declined among women aged 15-20 years, a group not typically screened for cervical cancer, which may suggest HPV vaccine impact.
Timely vaccination and improved screening and follow-up among recommended age groups could result in further reductions in invasive cervical cancer.
由于癌症发展所需的时间以及最近对宫颈癌筛查指南和建议的更改，部分原因是，在美国尚未记录人乳头瘤病毒（HPV）疫苗对宫颈癌的影响。这些更改使数据解释变得复杂。
我们使用涵盖美国 97.8％人口的基于人群的癌症登记数据，检查了 1999-2017 年间诊断为 15-29 岁女性的宫颈鳞状细胞癌（SCC）和腺癌（AC）的发病率。
趋势按年龄和组织学分层。使用 Joinpoint 回归计算每年宫颈癌发病率的年度百分比变化。
1999-2017 年，15-20 岁女性 SCC 发病率每年下降 12.7％，21-24 岁女性下降 5.5％，25-29 岁女性下降 2.3％。2010-2017 年间，15-20 岁女性 SCC 发病率下降幅度最大，每年下降 22.5％。总体而言，15-20 岁女性 AC 发病率每年下降 4.1％，21-24 岁女性下降 3.6％，25-29 岁女性下降 1.6％。2006-2017 年间，15-20 岁女性 AC 发病率下降幅度最大，每年下降 9.4％。
自 HPV 疫苗问世以来，15-20 岁女性的 SCC 和 AC 发病率均有所下降，而这一年龄组通常不进行宫颈癌筛查，这可能表明 HPV 疫苗的影响。
及时为推荐年龄组接种疫苗，并改善筛查和随访，可能会进一步降低宫颈癌的发病率。
