Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
Department of Obstetrics and Gynecology, Jichi Medical University Saitama Medical Center, Omiya-ku, Saitama, 330-8530, Japan.
BMC Infect Dis. 2020 Nov 5;20(1):808. doi: 10.1186/s12879-020-05513-6.
Although more than 10 years have passed since HPV vaccination was implemented, first as an interim programme (Emergent vaccine promotion programme) in November 2010, followed by incorporating into the National Immunization Programme in April, 2013 and suspended in June 2013, limited studies have investigated the HPV vaccine effectiveness against high-grade cervical lesions in Japan.
We collected the matched data of the results of cervical biopsy and history of vaccination from the Japan Cancer Society database. The subjects were women aged 20 to 29 years screened for cervical cancer between April, 2015 and March, 2017, and with information on HPV vaccination status. We estimated the relative risk of developing high-grade cervical lesions in vaccinated subjects using Poisson regression as compared to unvaccinated subjects.
Among the 34,281 women screened, 3770 (11.0%) were vaccinated. The prevalence of CIN2+ was statistically significantly lower in the vaccinated women as compared to the unvaccinated women (Vaccine Effectiveness (VE) =76%; RR = 0.24, 95% CI:0.10-0.60). High VE against CIN3+ was also observed (91%; RR = 0.09, 95% CI:0.00-0.42).
Women aged 20-29 years who received at least one dose of HPV vaccine had a significantly lower risk of high-grade cervical lesions than those not vaccinated. In Japan, HPV vaccination should be resumed in order to reduce the incidence of cervical cancer.
HPV 疫苗接种自 2010 年 11 月首次作为临时计划(紧急疫苗推广计划)实施以来,已经过去了 10 多年,随后于 2013 年 4 月纳入国家免疫计划,并于 2013 年 6 月暂停,在日本,针对 HPV 疫苗对宫颈癌前病变的有效性进行了有限的研究。
我们从日本癌症协会数据库中收集了宫颈活检结果和疫苗接种史的匹配数据。研究对象为 20 至 29 岁的女性,她们在 2015 年 4 月至 2017 年 3 月期间接受了宫颈癌筛查,且有 HPV 疫苗接种史。我们使用泊松回归比较了接种组和未接种组中发生高级别宫颈病变的相对风险。
在 34281 名接受筛查的女性中,3770 名(11.0%)接种了疫苗。与未接种疫苗的女性相比,接种疫苗的女性 CIN2+的患病率明显较低(疫苗有效性(VE)=76%;RR=0.24,95%CI:0.10-0.60)。还观察到对 CIN3+的高 VE(91%;RR=0.09,95%CI:0.00-0.42)。
20-29 岁的女性接种至少一剂 HPV 疫苗,与未接种疫苗的女性相比,宫颈癌前病变的风险显著降低。为了降低宫颈癌的发病率,日本应恢复 HPV 疫苗接种。